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Republic of the Philippines

Department of Education
Region IX, Zamboanga Peninsula
Division of City Schools
DIPOLOG PILOT DEMONSTRATION SCHOOL
Dipolog City

January 08, 2016

The Schools Division Superintendent


Division of Dipolog City
Dipolog City

Madam:

The undersigned was on sick leave of absences due to a major gynecological operation
effective September 07, 2015 to October 07, 2015. She extended her sick leave of absences from
October 08, 2015 to November 06, 2015 to avail of the Special Leave Benefits for Women
Under R.A 9710 (An Act for the Magna Carta for Women). But sad to note her December, 2015
salary was cut off for that absences.

In this connection, I would like to request for a refund of my salary for December, 2015.

Attached herewith are the documents in support of my claim for your perusal.

Hoping for your kind consideration and favorable action and approval.

Very Truly Yours,

Claire E. Lugo
Teacher I - DPDS

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