Republic of the Philippines

Department of Education
REGION IVA - CALABARZON
SCHOOLS DIVISION OFFICE OF SAN PEDRO CITY

RECORDS UNIT
DOCUMENT REQUEST FORM (DRF)

DRF Tracking No: _______________________________ Request Date: __________________________

Name: ___________________________________________
Designation/Position: ___________________________
Requested Document: (Please check.)
Certificate of Employment
Certificate of Employment with Compensation
Certificate of LAWOP/ No LAWOP
Certificate of Service Credits Earned/Balance
Certificate of Leave Credits Earned/Balance
Certificate of Remittances – GSIS Contributions
Certificate of Remittances – Pag-IBIG Contributions
Certificate of Remittances –PhilHealth Contributions
School/Unit: ___________________________
Contact No: ____________________________
Service Record
Certificate of No Pending Case
Photocopy of Payslip/Payroll
Certified True Copy of:
__________________________________
Others: _________________________
_________________________________

Purpose of Request: ______________________________________________________________________

I hereby authorize and consent Schools Division Office of San Pedro City to use, collect, and
process my request in accordance with the data privacy policies of the DepEd and the Data Privacy
Act of 2012 and its implementing rules and regulations.

______________________________
Signature over Printed Name
(Requestor)

 For document tracking purposes, please attach this form to the requested document.

Release Date/Signature: ____________________________________

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CLAIM STUB
DRF Tracking No: _______________________________
For follow up of request please email at records.sanpedro@deped.gov.ph.

Remarks: (To be filled out by SDO-Records Staff)

___________________________________________________________________
Please present this slip upon claiming your requested document.
Authorization letter and valid ID (if a representative will request/claim)