INTENTION TO RETIRE

December 5, 2022

HON. RUDIN T. BABANTE

Municipal Mayor
MacArthur, Leyte

Sir:

I hereby submit and certify my intention to retire in FY 2022 under RA 8291 (Retirement Law)
with details below:

Name: DELIA L. ULBATA Latest Annual Salary: PhP 244,824.00

Position: MIDWIFE I Authorized Monthly Salary: PhP 20,402.00
Office: MUN. HEALTH OFFICE

Number of Years in Government Service: 16 yrs.

Birthdate: May 27, 1959
Age at the time of Retirement: 63 yrs. old
Effective Date of Retirement: January 1, 2023
Last Day of Service: December 31, 2022
Leave Credits to Date: Vacation: 166.871 Sick: 203.333 Total: 370.204
Tentative Computation of Money Value of Leave Credits: PhP 363,994.74

Attached are my latest statement of service records and certification of leave credits for ready
reference.

I am fully aware that any wrong information contained in this form will lead to inaccurate
computation and possible delays in payment of benefits due me.

For this purpose, it is requested that amount of retirement benefits due me be included in the FY
2023 budget.

Very truly yours,

DELIA L. ULBATA
Midwife I

NOTED:

EMELIA G. ENCLUNA VENNIE V. LUMPAS

HRMO-Designate Mun. Accountant-Designate

APPROVED:

RUDIN T. BABANTE
Municipal Mayor