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EQUIVALENT RECORD FORM CHECKLIST EQUIVALENT RECORD FORM CHECKLIST

(FOR TEACHER III) (FOR TEACHER III)

Name : ___________________________ Name : ___________________________


Position : ___________________________ Position : ___________________________
Division/School: ___________________________ Division/School: ___________________________

_______ Endorsement from the PSDS _______ Endorsement from the PSDS
_______ Duly accomplished ERF – 5 copies _______ Duly accomplished ERF – 5 copies
_______ At least 3 years or more teaching experience _______ At least 3 years or more teaching experience
with CAR/MA graduate or 20 years teaching with CAR/MA graduate or 20 years teaching
experience with 20 or more MA units experience with 20 or more MA units

_______ Original copy of Certification from School _______ Original copy of Certification from School
Registrar for MA Units or C.A.R. Registrar for MA Units or C.A.R.
_______ TOR with Certification, Authentication and _______ TOR with Certification, Authentication and
Verification (CAV) from CHED – original copy Verification (CAV) from CHED – original copy
_______ Updated Service Record – 3 original copies _______ Updated Service Record – 3 original copies
_______ Performance Rating for the last 3 School Years _______ Performance Rating for the last 3 School Years
(certified photocopy signed by the (certified photocopy signed by the
Administrative Administrative
Officer, District Supervisor and School Head) Officer, District Supervisor and School Head)
– 1 copy/year ( in consecutive order) – 1 copy/year ( in consecutive order)
_______ Duly accomplished CS Form 212 (Personal Data _______ Duly accomplished CS Form 212 (Personal Data
Sheet) – 3 original copies Sheet) – 3 original copies
_______ Sworn Statement that all documents submitted _______ Sworn Statement that all documents submitted
are true and correct with documentary stamp are true and correct with documentary stamp
(original copy) (original copy)
_______ Latest approved appointment – 3 certified true _______ Latest approved appointment – 3 certified true
copies copies
_______ Latest Payslip or Payroll – 1 certified true copy _______ Latest Payslip or Payroll – 1 certified true copy
_______ Latest Plantilla (PSIPOP) – 1 certified true copy _______ Latest Plantilla (PSIPOP) – 1 certified true copy
_______ Certificates of trainings, seminars, workshops, _______ Certificates of trainings, seminars, workshops,
awards – certified true copies awards – certified true copies
_______ Certification that the incumbent of the position _______ Certification that the incumbent of the position
to be Reclassified qualifies to occupy the new to be Reclassified qualifies to occupy the new
position position

Checked by : ______________________________ Checked by : ______________________________


School/District In-charge School/District In-charge

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