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Department of Education: Equivalent Record Form (Erf)

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Republic of the Philippines

Department of Education
SOCCSKSARGEN REGION
Division of GENERAL SANTOS CITY
EQUIVALENT RECORD FORM (ERF)
School: District:

Name: Date of Birth: Gender:


(Surname) (Given) (Middle)
Employee No. Authorized Position Title:
Item No. ____________________________Authorized Salary: __________________Present SG rcvd:______Step:

I. EDUCATIONAL ATTAINMENT AND CIVIL SERVICE ELIGIBILITY:


Titles, Degree
Year Civil Service
Highest Grade Name of Institution Rating Date
Received Examination
Attained

II. SERVICE RECORDS (ATTACH DULY CERTIFIED SERVICE RECORD)

III. EQUIVALENT UNITS


A. Total number of years teaching: (Public only) ___________________________________ Equivalent________________
B. Degree to Degree Equivalent: Present Degree __________________________________ Equivalent ________________
SCHOOL NO OF
DESCIRPTION
C. Areas of Equivalents: YEAR UNITS
1. Professional Study:
2. Teaching Experiences:
a. Public Schools
b. Private Schools
3. Adm. Supervisory Experience:
a. Public Schools
b. Private Schools
4. Others (Seminars, Workshops, etc.)
TOTAL

LATEST EFFICIENCY Numerical:


RATING: Adjectival:
Conforme:

Name and Signature of Applicant (Name and Signature of PIC/PSDS)

Note: TEACHERS-Do not write below.


IV. DIVISION ACTION
Range Scheduled
Classification Date Processed Salary Range Remarks
Assignment Salary

CERTIFIED CORRECT: RECOMMENDING APPROVAL:

CARLOS G. SUSARNO,PhD,CESE ROMELITO G. FLORES, CESO V


Schools Division Evaluator Schools Division Superintendent

V. DepEd-REGIONAL OFFICE ACTION:


EVALUATED BY:

LEONARDO B. MISSION PhD MICHAEL A. POBLADOR JOVEL S. HUNAS


Education Program Supervisor-Chairman Education Program Supervisor-Member Teacher Credentials Evaluator II

CERTIFIED CORRECT: APPROVED:


CARLITO D. ROCAFORT
KATHRINE H. LOTILLA Director III
Supervising Administrative Officer OIC-Office of the Regional Director
JSH/AD-P/ERF-SH/_____/________
PLEASE FILL-UP AT THE BACK

Regional Center, Brgy. Carpenter HIll, City of Koronadal


Telefax No.: (083) 2288825/ (083) 2281893
Website: depedroxii.org Email: region12@deped.gov.ph
Republic of the Philippines
Department of Education
SOCCSKSARGEN REGION
VI. DepEd PROPER ACTION

I hereby certify that under oath that I have actually enrolled in the school or schools in the accompanying
transcript of records that I have earned the units and/or graduated as indicated therein.

As required, the Bureau of Public Schools or the Department of Education has been furnished with
authentic of the Sworn Statement and its enclosures.

(Teacher's Printed Name and Signature)

SUBSCRIBED AND SWORN to before me this _______day of ___________________,20______ affiant


exhibiting his/her Residence Certificate No. ______________________ at _______________________________
on ________________________________.

Signature of Person Administering Oath

Doc No.:
Page No.:
Book No.:
Series of:
DO/Page:

JSH/AD-P/ERF-SH/00___/May 31,2021

Regional Center, Brgy. Carpenter HIll, City of Koronadal


Telefax No.: (083) 2288825/ (083) 2281893
Website: depedroxii.org Email: region12@deped.gov.ph

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