Republic of the Philippines

Department of Education Republic of the Philippines

Region viii-eastern Visayas Department of Education
schools division of northern samar Region viii-eastern Visayas
Catarman National High School schools division of northern samar
Catarman National High School
CHECKLIST FOR DAILY TIME RECORD (CSC Form 48)
PLEASE DO NOT DETACH CHECKLIST FOR DAILY TIME RECORD (CSC Form 48)
PLEASE DO NOT DETACH
Name of Employee: _____________________________________________
Please submit in two (2) sets (1 for COA and 1 for School File). Write “N/A” in Name of Employee: _____________________________________________
the spaces provided if Not Applicable. Please submit in two (2) sets (1 for COA; 1 for School File). Write “N/A” in the
spaces provided if Not Applicable.
________ Duly Accomplished Daily Time Record (CSC Form 48)

Required Attachments ________ Duly Accomplished Daily Time Record (CSC Form 48)
________ Printed Biometric DTR Required Attachments
________ Photocopies of Log Sheet ________ Printed Biometric DTR
On Official Business/Travel ________ Photocopies of Log Sheet
________ Locator Slip On Official Business/Travel
________ Authority to Travel ________ Locator Slip
________ Certificate of Appearance ________ Authority to Travel
________ Memorandum ________ Certificate of Appearance
On Personal Business/Travel ________ Memorandum
________ Individual Pass Slip for Personal Business On Personal Business/Travel
Leave of Absence ________ Individual Pass Slip for Personal Business
________ Approved Application for Leave (CSC Form 6) Leave of Absence
Leave of Absence due to Quarantine and/or Treatment relative to COVID- ________ Approved Application for Leave (CSC Form 6)
19 Leave of Absence due to Quarantine and/or Treatment relative to COVID-
________ Certificate issued by government/private physician 19
________ Completion of Quarantine Certificate issued by the local quarantine/ ________ Certificate issued by government/private physician
health official ________ Completion of Quarantine Certificate issued by the local quarantine/
________ Medical Certificate health official
________ Medical Records ________ Medical Certificate
I hereby certify that the supporting documents as required are complete and ________ Medical Records
hereto attached. I hereby certify that the supporting documents as required are complete and
___________________________________________ hereto attached.
Signature of Employee/Date ___________________________________________
Signature of Employee/Date
Received by: ______________________________________ Date: ________________________
Received by: ______________________________________ Date: ________________________

Republic of the Philippines

Department of Education Republic of the Philippines
Region viii-eastern Visayas Department of Education
schools division of northern samar Region viii-eastern Visayas
Catarman National High School schools division of northern samar
Catarman National High School
CHECKLIST FOR DAILY TIME RECORD (CSC Form 48)
PLEASE DO NOT DETACH CHECKLIST FOR DAILY TIME RECORD (CSC Form 48)

Name of Employee: _____________________________________________ PLEASE DO NOT DETACH

Please submit in two (2) sets (1 for COA; 1 for School File). Write “N/A” in the Name of Employee: _____________________________________________
spaces provided if Not Applicable.
Please submit in two (2) sets (1 for COA; 1 for School File). Write “N/A” in the
spaces provided if Not Applicable.
________ Duly Accomplished Daily Time Record (CSC Form 48)

Required Attachments ________ Duly Accomplished Daily Time Record (CSC Form 48)
________ Printed Biometric DTR
Required Attachments
________ Photocopies of Log Sheet
________ Printed Biometric DTR
On Official Business/Travel ________ Photocopies of Log Sheet
________ Locator Slip
On Official Business/Travel
________ Authority to Travel
________ Locator Slip
________ Certificate of Appearance
________ Authority to Travel
________ Memorandum
________ Certificate of Appearance
On Personal Business/Travel ________ Memorandum
________ Individual Pass Slip for Personal Business
Leave of Absence On Personal Business/Travel
________ Approved Application for Leave (CSC Form 6) ________ Individual Pass Slip for Personal Business
Leave of Absence
Leave of Absence due to Quarantine and/or Treatment relative to COVID- ________ Approved Application for Leave (CSC Form 6)
19
________ Certificate issued by government/private physician Leave of Absence due to Quarantine and/or Treatment relative to COVID-
19
________ Completion of Quarantine Certificate issued by the local quarantine/
________ Certificate issued by government/private physician
health official
________ Completion of Quarantine Certificate issued by the local quarantine/
________ Medical Certificate
health official
________ Medical Records
________ Medical Certificate
I hereby certify that the supporting documents as required are complete and ________ Medical Records
hereto attached.
I hereby certify that the supporting documents as required are complete and
___________________________________________ hereto attached.
Signature of Employee/Date
___________________________________________
Signature of Employee/Date
Received by: ______________________________________ Date: ________________________

Received by: ______________________________________ Date: ________________________