Republic of the Philippines

Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO CITY

(date)__________________

REYNANTE A. SOLITARIO, CESO VI

Schools Division Superintendent
E. Quirino Avenue, Davao City
,
Sir:

This is to formally submit my intention to be separated from the Department of

Education, Schools Division of Davao City, effective ______________________ (date )
Due to: ( Please check the appropriate box )
‫ﬦ‬ Optional Retirement (age 60-64)
‫ﬦ‬ Mandatory Retirement (effective the day after the 65th birthday)
‫ﬦ‬ Resignation / Separation (below age 60)
‫ﬦ‬ Transfer of Agency / Division ; to : __________________________
Number of years in service: _____________________________________
Item Number: _____________________________________
Position / Title: _____________________________________
School / Office: _____________________________________
District: _____________________________________
Employee Number: _____________________________________
Pag-Ibig Number: _____________________________________
GSIS BP Number: _____________________________________
Date of Birth: _____________________________________

Thank you very much.

Very truly yours,

__________________________________
(Signature over printed name)

Recommending Approval:
____________________________
(School Head/PSDS/Division Chief)

Approved by:

REYNANTE A. SOLITARIO, CESO VI

Schools Division Superintendent

Address: Elpidio Quirino Avenue, Davao City

Telephone No: (082) 224-3274, (082) 222-1672
E-mail: davao.city@deped.gov.ph