Department of Education SDO Makati — Records Unit RELEASED ‘Republic of the Philippines ‘ay | BY: —tALAINE Bepartment of Education | §,.' senor wmaTST NATIONAL CAPITAL REGION SCHOOLS DIVISION OFFICE OF MAKATI @URTROL NUMBER -2021-05-200 Office of the Schools Division ‘Superintendent 25 May 2021 DIVISION MEMORANDUM , 8. 2021 CHECKLIST OF REQUIREMENTS FOR VARIOUS PROCESSES UNDER PERSONNEL UNIT AND NEW AND REVISED CSC LEAVE FORMS TO: OIC-Office of the Assistant Schools Division Superintendent Chief, Education Supervisor, SGOD OIC-Chief Education Supervisor, CID Education Supervisors Public Schools District Supervisors Elementary and Secondary School Heads and OICs All Concerned To facilitate processing of requests for various personnel actions, attached is the Checklist of Requirements for Various Processes under Personnel Unit. All the forms required may be downloaded from the agency website. Also attached are the following new and revised forms from the Civil Service Commission: 1. Civil Service Form No. 6 Revised 2020 Application for Leave; 2. CS Form No. 6a Series of 2020 Notice of Allocation of Maternity Leave All forms must be used effective immediately, For information and compliance. Office of the ‘chools Division Superintendent Bana © ov. Noble st, Guadalupe Nuevo, Makati ity es @ (02}8882-5861; (02) 3882-5862 © inakaticity @éeped.gov.ph @ www.depedmakatiphCHECKLIST OF REQUIREMENTS OF VARIOUS PROCESSES UNDER PERSONNEL UNIT AS OF MAY 2021 APPOINTMENT PROCESS ‘A. NEW HIRE 1. DBM-CSC Form No. 1 Position Description Form (Guly signed by the Principal/ Immediate Supervison 2. CS Form No, 212 Personal Data Sheet (Revised 2017) with passport sae ID pictute in business altire, and signature over printed name on the picture 3. CS Form No, 212 Attachment Work Experience Sheet 4. CS Form No. 4 Certification of Assumption to duty 5. CS Form No. 32 Oath of Office 6, Sworn Statement of Assets, Liabilities and Net Worth (SALN) duly notarized 7. CS Form No. 211 Medical Certificate (certified by a Government Physician} (Urinalysis, Chest X-Ray, Hematology, Drug Test Result ~ Metampethamine and Cannabincid) 8. Transcript of Records 9. Service Records 10. Certificate of Eligibility 11. PRC ID 12. NBI Clearance (original copy) 13. Latest IPCRF 14, Photocopy of Birth Certificate/Marriage Certificate (if Married) 15, BIR Tax Identification Number (for new hires) 16. BIR withholding Tax Certificate-1902 (for new hires) 1905 and 2305 (for Transfer) 17. Employee’s Compensation and withholding Tax Certificate (BIR 2316) 18. Philhealth Membership Registration Form (PRMF) (for new hires) 19. Home Development Mutual Fund (HDMI) Member's Data (for new hires) B. PROMOTION 1., DBM-CSC Form No. I Position Description Form {duly signed by the Principal for “Immediate Supervisor’, for School personnel) 2. CS Form No. 212 Personal Data Sheet (Revised 2017) with passport size ID picture in business attire, and signature over printed name on the picture 3. CS Form No. 212 Attachment Work Experience Sheet 4. CS Form No. 4 Certification of Assumption to duty 5. CS Form No, 32 Oath of Office 6. Sworn Statement of Assets, Liabilities and Net Worth (SALN} (duly notarized by Prineipal for premetion) 7. CS Form No. 211 Medical Certificate (certified by a Government Physician) (Urinalysis, Chest X-Ray, Hematology, Drug Test Result - Metampethamine and Cannabinoid) 8. Service Records 9. Certificate of Eligibility 10. PRC ID 11, NBI Clearance (original copy} 12. Latest IPCRF ©. TRANSFER 1, DBM-CSC Form No. 1 Position Description Form (duly signed by the Principal Immediate Supervisor) 2. CS Form No. 212 Personal Data Shect (Revised 2017) ‘with passport size ID picture in business attire, and signature over printed name on the picture 3. CS Form No. 212 Attachment Work Experience Sheet 4. CS Form No. 4 Certification of Assumption to dutyCS Form No. 32 Oath of Office Sworn Statement of Assets, Liabilities and Net Worth (SALN) duly notarized CS Form No. 211 Medical Certificate (certified by a Government Physician) (Urinalysis, Cheat X-Ray, Hematology. Drug Test Result ~ Metampethamine and Cannabinoid) ‘Transcript of Records. 9. Service Records 10. Certificate of Eligibility 11. PRC ID 12. NBI Clearance (original copy) 13. Latest IPCRF 14. Photocopy of Birth Certificate/ Marriage Certificate {if Married) 15. BIR withholding Tax Certificate-1902 (for new hires) 1905 and 2305 (for ‘Tranafer) LEAVE APPLICATION A. SICK LEAVE/MAGNA CARTA FOR WOMEN (RA 9710) Letter of intent duly endorsed by the School Head/Immediate Supervisor} CSC Form No. 6 (Application for Leave} CS Form No. 41 (Medical Certificate for 5 days and above) Report of last day of service Required clearances {for 1 month and above) Medical Abstract (for leave for Magna Carta for Women) ousene B. MATERNITY LEAVE 1. Letter of intent duly endorsed by the School Head /Immediate Supervisor) 2. CSC Form No. 6 (Application for Leave) 3. CS Form No. 41 (Medical Certificate) 4. Report of last day of service 5. Required clearances C. PATERNITY LEAVE 1. CSC Form No. 6 (Application for Leave) 2. Birth Certificate or Histopath Result 3. Certified True Copy of Marriage Contract *~* applicable for first 4 deliveries of legitimate spouse D. VACATION LEAVE 1, CSC Form No. 6 (Application for Leave) 2. Letter of intent duly endorsed by the School Head /Immediate Supervisor (for more than 5 days leave} 3. Required clearances (for | month and above) B. REHABILITATION LEAVE 1. Letter of intent duly endorsed by the School Head /Immediate Supervisor) 2. CSC Form No. 6 (Application for Leave) 3. CS Form No. 41 (Medical Certificate duly concurred by the Government Physician) 4. Incident/Police report 5. Copy of Memorandum such as: (whatever is applicable) ~ Detail Order = Special Assignment ~ Authority to Render Overtime ~ Authority to Travel6. Report of last day of service 7. Required clearances (for 1 month and above) F. SPECIAL PRIVILEGE AND FORCED LEAVE 1. CSC Form No. 6 (Application for Leave) ‘with appropriate action of the Immediate Supervisor @. PARENTAL LEAVE (SOLO PARENT LEAVE) 1. CSC Form No. 6 (Application for Leave) 2. Copy of valid Solo Parent Identification Card 3. Any valid proof that such leave will be used to perform Parental Obligation HH. ANTLVIOLENCE AGAINST WOMEN AND THEIR CHILDREN LEAVE (RA 9262) 1. CSC Form No. 6 (Application for Leave) 2. Any of the following supporting documents: - Medical Certificate - Police Report - Barangay Protection Order obtained from the barangay - Temporary/Permanent Protection Order obtained from the court - Certification from barangay or Prosecutor or Clerk of Court that the application for BPO/TOP/PPO has been filed I. SABBATICAL/STUDY LEAVE 1. Letter of intent duly endorsed by the School Head /Immediate Supervisor 2. CSC Form No. 6 (Application for Leave) 3. Sabbatical Leave Agreement/Memorandum of Agreement 4. Copy of approved Permit to Study J. LEAVE DUE TO QUARANTINE AND/OR TREATMENT RELATIVE TO COVID-19 (Q4C NO. 8, s. 2020) 1. Letter of intent duly endorsed by the School Head /Immediate Supervisor 2. CSC Form No. 6 (Application for Leave) 3. Certificate issued by Government/Private Physician that he/she has submitted himself/herself for monitoring/ investigation, as applicable (for PUM and PUI) 4. Completion of Quarantine Certificate issued by the local quarantine/health official; 5. Medical Certificate that he/she is cleared to report back to work and medical records showing that he/she was treated of the COVID-19 signed by the attending physician (for those under treatment of COVID-19) RETURN TO DUTY FROM LEAVE OF ABSENCE Letter of intent duly endorsed by the School Head/Immediate Supervisor CS Form No. 211 (Medical Certificate duly signed by the Government Physician if possible) Birth Certificate (for live birth) or Histopath Report (for miscarriage) ‘Transcript of Records and Accomplishment Report for Sabbatical Study Leave Report on the first day of service Beer CHANGE OF NAME/MARITAL STATUS 1. Letter of intent duly endorsed by the School Head/Immediate Supervisor 2. PSA copy of Marriage Certificate and or/or Birth Certificate 3. Duly received Member's Change of Information Form from Pag-ibig 4. Duly received Member's Change of Information Form from PhilhcalthPERMIT TO STUDY 1. Duly accomplished and signed Application for Permit to Study Form 2. Certificate of Registration PERMIT TO TEACH/PRIVATE PRACTICE OF PROFESSION 1. Letter of intent duly endorsed by the School Head /Immediate Supervisor; 2. Duly accomplished and signed Application Form/Permit to Teach: 3. CS Form No. 211 (Medical Certificate duly signed by the Government Phy: possible); 4. Certification of Class Schedule/Teaching from the institution or Terms of Reference for Private Practice of Profession; 5. Latest Performance Rating ian, if APPLICATION FOR RESIGNATION INITIAL PROCESS: 1. Letter of intent duly endorsed by the School Head/Immediate Supervisor ‘SECOND PROCESS: School Clearance (duly signed by authorized signatories) 2. CS Form No. 7 Division Clearance (duly signed by authorized signatories) 3. Certificate of No Pending Case issued by DepEd-NCR Legal Unit) {for teaching/supervisory positions 4. Certificate of Last Payment 5. Service Record RETIREMENTAPPLICATION INITIAL PROCESS: 1. Letter of intent duly endorsed by the School Head/Immediate Supervisor SECOND PROCESS: 1. GSIS Form No. 06302017-RET Application for Retirement/Separation/Life Insurance Benefits (duly accomplished/ signed by retiree and signed by Head of Agency) 2. School Clearance (duly signed by authorized signatories) 3. CS Form No. 7 Division Clearance (duly signed by authorized signatories) 4. DepED-NCR Clearance (for Principal retirees) 5. Certificate of No Pending Case (issued by DepEd-NCR Legal Unit) {or teaching/ supervisory positions 6. Certificate of Last Payment 7. Service Record 8. Certificate of Leave with/without Pay 9. Certificate of Last Day of Service 10. Division Certification 11. Sworn Statement of Assets, Liabilities and Net Worth (SALN) duly notarized (as of the last day of service) 12, Declaration of Pendency/Non-Pendency to be notarized and submitted upon advise by sis) 13, Ombudsman Clearance‘MATURITY CLAIM BENEFITS A. 3. 4 GSIS Form No. 06302017-RET Application for Retirement/Separation/Life Insurance Benefits (duly accomplished/ signed by applicant and signed by Head of Agency) Certificate of No Pending Case (issued by DepEd-NCR Legal Unit) for teaching/aupervisory positions Service Record Certificate of Leave With/Without Pay APPLICATION FOR EQUIVALENT RECORD FORM (RECLASSIFICATION) A. TEACHER I & I POSITIONS 1. Duly accomplished Equivalent Record Form (IRF) (3 original copies); 2. Service Records; 3. Authenticated copy of Transcript of Records in the Masteral Course signed by the School Registrar; 4. Permit to Study or Accreditation of Units; and 5. Copy of approved curriculum for masteral course 'SPED TEACHER I - HI POSITIONS Duly accomplished Equivalent Record Form (ERF) (3 original copies}; Authenticated copy of Transcript of Records in the Masteral Course signed by the School Registrar; Service Records; Certificates of relevant training for the last five years (at least 24 hours); Permit to Study or Accreditation of units in the Masteral Course; “Certification that the candidate has Very Satisfactory ratings for the last threc (3) years (IPCRF) and ***has three (3) years experience teaching children in any of the categories of children with special needs signed by the Principal and attested by the Schools Division Superintendent; 7. **Data on the number of learners enrolled in the category of children with special needs handled by the Candidate; 8. Justification(s) for the need of the position; 9, Rank List of all personnel who are qualified for the desired position, duly signed by the Chairman and Members of the Ranking Committee, and attested by the Schools Division Superintendent or Certification that the applicant is a lone candidate (2 copies); wie euae “with template HEAD TEACHER I - VI POSITIONS . Duly accomplished Equivalent Record Form (ERF) (3 copies); Authenticated copy of Transcript of Records in the Masteral Course signed by the school registrar); Service Records; Certificates of relevant training for the last five years (at least 24 hours); Permit to Study or Accreditation of Units in the Masteral Course; “* Certification that the Candidate has Very Satisfactory ratings for the last three (3) years (IPCRF); ** List of teachers in each of the eight (8) major subject areas, duly identified by their respective item number per Plantilla of Personnel, each page duly signed /certilied correct by the head of the school and attested by the Schools Division Superintendent/or duly authorized signatory (2 copies); 8. Updated copy of the school’s Plantilla of Personnel for the current Fiscal Year - please mark/highlight the names of the teachers in the subject area of the teacher for reclassification (1 copy); 9. Justification(s) for the need of the Position; 10. SF 7 for current school year (1 copy}; 11, Rank list of all personnel who are qualified for the desired position duly signed by the Chairman and Members of the Ranking Committee, and attested by the oyee x 5Schools Division Superintendent or Certification that the applicant is a Tone candidate (2 copies}; with template LOAN APPLICATION A. GSIS (Regular, Calamity and Multi-Purpose Loans) 1. Certified true copy of latest Payslip B. PAGBIG (Regular and Calamity Loans) 1. Pag-ibig Application Form (duly accomplished) 2. Certified true copy of latest Payslip 3. Photocopy of valid 1D ©. PRIVATE LENDING INSTITUTIONS (PLI) 1. Application Form (evaluated/stamped and emailed by concerned PLI) 2. Latest Paystip (evaluated /stamped and emailed by concerned Li) D. DECS-PROVIDENT FUND 1, Application Form (duly accomplished) 2. Cettified true copy of latest Payslip 3. Certificate of No Pending Case (issued by DepE¢-NCR Legal Unit) 4. Photocopy of valid 1DRepublic of the Philippines Department of Education ‘ational Capital Region ‘Schools Division Office of Makati Citv APPLICATION FOR LEAVE 1. OFFICE/DEPARTMENT 2.NAME: (Last) irs) (idiey JS. DATE OF FILING 4, POSITION 5. SALARY ———— 6. DETAILS OF APPLICATION |6.A TYPE OF LEAVE TO BE AVAILED OF lo.B DETAILS OF LEAVE 1 Vacation Leave sR ns Rie npg 0 2 D1 MandatorytForced Leaves: 25 Onna Ra epi Ni, 22) Sick Leave (sa: «fb Onntas Rue nsereng 0 Na 22) Di Maternity Leave peo. 121, 1RR ity C80, 001 nd 83) 1 Patemity Leave (a to #871650 WC Na 7. eng 1 special Privilege Leave se: 2, eM Cun Rue sanan EN 22) 1 Solo Parent Leave rate 272/030 0 es Za A study Leave se: 6, ie Conte Rls main 1.22) 1 to-day VAWC Leave frie sa sosc are 15.9205) C1 Rehabilitation Privilege (sa: 5 fe, Conta Ras nperening 0s 22) 1 Special Leave Benefits for Women jr i/eso¥ci 5 = 20) C. Special Emergency (Calamity) Leave (suc a2 21,2: 3m) 1 Adoption Leaver ns 22 Others: Incase of Vacation/Special Privioge Leave: 1D Wahin the Phiippines D Abroad ¢Specity, Incase of Sick Leave: Di tnHospitat (Speci tness) 1 out Patient (Spectyiiness) Incase of Special Leave Benefits for Women, (Gpeatytiness) In case of Study Leave: Ci Completion of Master's Degree Cl BAR Board Examination Review Other purpose: Ci Monetization of Leave Credits Gi Terminal Leave [e.c NUMBER OF WORKING DAYS APPLIED FOR INCLUSIVE DATES. [6.0 COMMUTATION CI Not Requested Ci Requested ‘Gianature oF Appian) [7A CERTIFICATION OF LEAVE CREDITS Asot Vacalion Leave Total Eamed TLaSs this application Balance CHRISTINA P. SANTOS. ‘Aatnsraive Omar 7. DETAILS OF ACTION ON APPLICATION ee ee ee 178 RECOMMENDATION C1 For approval 1 For disapproval due to (Gathorized Oricar) 17.c APPROVED FOR: days with pay ‘days without pay others (Specify) 7.D_ DISAPPROVED DUE TO: CARLEEN S. SEDILLA, CESE Assistant Schools Division Supertendont he ihe Schools Ocion Suparniandent6S Form No. 62 Series of 2020, NOTICE OF ALLOCATION OF MATERNITY LEAVE 1. FOR FEMALE EMPLOYEE NAME (Last Name, Firs Name, Namie Extension, Fany, and Wide Nama) TION HOWE ADDRESS. "AGENCY and ADDRESS ‘CONTACT DETAILS (Phane number and e-mail address 1am alocating __ cays (7 days max.) of my 105:-day maternity leave fo Mr.A4s Uthich benef is oranied Under Republic Act No, 11210 or the 105-Day Expanded Materily Law. Alachod We Tho prool of our relationship __TSIGHATURE OVER PRINTED NAME _ aa FOR CHILD'S FATHER/ALTERNATE CAREGIVER POSMTION “AGENCY [EMPLOYER and ADDRESS RELATIONSHIP TO THE FEMALE EMPLOYEE (lease mark te box wy 2) J accept the allocated ___ days of the 105:day matemity eave chan ears from the abovementionad toma omployee and tsve submit the attached ‘roof of our retaionship. it’s understood thatthe alfocated maternity leave Daaltemate caregiver {sor the care of ourfer newborn child. ORelatve within fourth degree of consanguinity (Specty {Glourrent partner sharing the same houschold_| —— SIGNATURE OVER PRINTED NAME DATE ‘PROOF OF RELATIONSHIP (Please mark the box with and attach 2 photocopy ofthe document) [Marriage Cerifcate | Ci Barangay Certicate | CiOiher bona fide documents that can rove fla eationship Ti FOR THE HRMO AND THE HEAD OF OFFICE/AUTHORIZED OFFICIAL ‘APPROVED: | catty that ts [- ‘has a matemty cave balance of days. Furthermore, | hhave reviewed and evaluated The attoched supporting ‘documents and find the herein allocation of maternity leave CARLEEN 8. SEDILLA, CESE. xd ‘isltant Schools Division Superintendent Offcerin-Chorge ffce of the Sonoats Diveion Superintendent (CHRISTINA P. SANTOS. Administrative OffeerIV ‘DATE _ DATE [ AGENCY, ADDRESS: INTACT DETAILS i____ instructions The form shall be used as written notice of the female employee to her agency regarding her allocation of a maximum of seven (7) days from the 105-day expanded matemity leave. The form shall be accomplished in three (3) copies: copy for the female employee; copy for the agency; and copy for the agency/employer of the child's father/alternate caregiver. .. The form with proof of relationship shall be attached to the Application for Leave (CS Form No. 6) of the female employee. . The authorized official shall forward the copy for the agency/employer of the child's fatherlalternate caregiver. ._ Item | of the form shall be accomplished by the female employee. She shall provide the required personal and agency information, the number of maternity leave days ‘sought to be allocated and the name of the recipient of the allocated leave. She shall affix her signature over printed name with date of signing. tem II of the form shall be accomplished by the child's fatherfaltemate caregiver. He/she shall provide the required personal and agency/employer information and he/she shall affix his/her signature over printed name with date of signing. item IIL of the form shall reflect the name of the female employee and her maternity leave balance. This part shall_be accomplished and signed by the Human Resource Management Officer (HRMO) in the agency. It is a ministerial duty of the head of office or his/her authorized official to approve said allocation and indicate the date of signing. The agency, thru the HRMO, is responsible to forward a copy of the accomplished form to the agency/employer of the child's fatheralternate caregiver.