Republic of the Philippines

Department of Education
Region VIII
DIVISION OF EASTERN SAMAR
Borongan City

CHECKLIST OF REQUIREMENTS FOR APPOINTMENT PREPARATION

Name GINA C. BARROS Vice ____________________________________

School NICASIO M. ALVAREZ II MEMORIAL NHS Nature of Vacancy ________________________
District/Municipality ORAS EAST Effective date of Vacancy __________________
Position Title _TEACHER II Date of Publication _______________________
Nature of Appointment RECLASSIFICATION Item No. ________________________________

Checked by personnel in-charge as to proper

DOCUMENTS TO BE SUBMITTED accomplishment of PDS and PDF and as to
completeness of documents (place tick mark
Arrange documents in accordance with the sequence indicated below and affix signature if in order)

A. FOR REEMPLOYMENT/ORIGINAL APPOINTMENT Yes No Remarks

1. Appointment Preparation Checklist - 1 copy
2. Appointment Proposal – 3 copies
3. Personal Data Sheet (CS Form No. 212, Revised 2017) in 3 sets w/
Passport Size I.D. Picture WITH NAME TAG AND SIGNATURE (1.77"x1.37")    
3. Position Description Form (BC-CSC Form No. 1) - 3 copies    
4. Oath of Office/Panunumpa (w/ documentary stamp per copy) - 3 copies    
5. Updated PRC License w/ PRC (Good Standing and/or Lupon) (duly
authenticated) - 3 copies    
6. PBET/LET Report of Rating - (duly authenticated) - 3 copies    
7. Transcript of Records (duly authenticated) - 3 copies    
8. Ranklist/Approved ERF (District or Div. Ranking) duly authenticated - 3 copies    
9. Medical Certificate (CS Form NO. 211 - 3 copies w/ doc. Stamp attached per copy)
w/ results in the Pre-employment Mental-Physical-Medical Examinations consisting
of original copies of BLOOD TEST, URINALYSIS, CHEST X-RAY, DRUG TEST
and NUEROPSYCHIATRICT EXAM. - 3 copies    
10. NBI Clearance (duly authenticated) - in 3 copies w/ original copy    
11. Statement of Assets, Liabilities and Networth (notarized) - 3 copies    
12. NOSCA for Newly Created Position - 3 copies for each set    
13. Marriage Contract (female applicant) if married    
14. Live Birth – duly authenticated by NSO/PSA    
B. FOR APPOINTMENT BY TRANSFER    
1. A - No. 1-7    
2. Updated Service Record - 3 copies    
3. Approved Performance Rating for the last 3 rating period, 3 copies duly authenticated    
4. Approved Swapping Agreement, if applicable, 1 copy duly authenticated    
5. Marriage Contract (if name has been changed from the last appointment)    
6. NOSCA for Realignment ( 3 copies) – if applicable
Additional requirements for Transfer from Region/Division to another    
6. Approved S.O for Transfer/Separation - duly authenticated in 3 copies
7. Certification of the Last Day of Service    
8. Certification of the Last Salary Received    
9. Certification of Unused Service Credits    
10. Division & School Clearance from financial obligations and property
accountability from former office    
11. Clearance/Certification that has no pending administrative/criminal case.    
C. FOR PROMOTION, RECLASSIFICATION OR UPGRADING    
1. A - No. 1-8    
2. Latest Approved Appointment - 3 copies    
3. Marriage Contract (if name has been changed from the last appointment)    
4. Approved Performance rating for the last 3 rating periods - 3 copies    
5. Updated Service Record - 3 copies    
Additional requirements for Reclassification:    
6. PAL w/ NOSCA for Reclassification - 3 copies

Reviewed by: OFELIA A. GELINA

District/School Personnel In-Charge