Department of Education

Region X
Division of Bukidnon
District of Baungon II
Danatag Elementary School
Danatag, Baungon, Bukidnon

Date ____________

DIVISION OF SPECIAL ORDERS

No. _______, s. _______

CHANGE OF OFFICIAL NAME DUE TO MARRIAGE

It is hereby made a matter of record that due to a legal marriage, the official name of the
following teacher/ employee in this Division has been changed effective the date of marriage:

MAIDEN NAME MARITAL NAME

LUCELLE I. GOLOSINO LUCELLE G. ALIM

DATE OF MARRIAGE STATION

MAY 19, 2018 DANATAG ELEMENTARY SCHOOL

CHERRY MAE L. LIMBACO, Ph. D., CESO V

School Division Superintendent

(Designation)

Copy Furnished:
1. Teacher Concern
2. District Supervisor
3. CSC, Region X
4.DEPED, Region X
5. IBM, DEPED Manila
6. GSIS File
7. Division Office File
 Department of Education
Region X
Division of Bukidnon
District of Baungon II
Danatag Elementary School
Danatag, Baungon, Bukidnon

FIRST ENDORSEMENT

Respectfully forwarded to the School’s Division Superintendent, Division of Bukidnon,

Sumpong, Malaybalay City the application letter for a change of status and a change of name of
Miss LUCELLE I. GOLOSINO, Public School Teacher I of Danatag Elementary School, Danatag,
Baungon, Bukidnon

JULITO M. CAÑADILLA
School Principal I
 Department of Education
Region X
Division of Bukidnon
District of Baungon II
Danatag Elementary School
Danatag, Baungon, Bukidnon

June 22, 2018

CHERRY MAE L. LIMBACO, Ph.D., CESO V

Schools Division Superintendent
DepEd-Division of Bukidnon
Sumpong, Malaybalay City, Bukidnon

Madam:

I have the honor to apply for a change of status from single to married and a change of
name from Miss Michelle C. Sale to Mrs. Michelle S. Nakamura by virtue of my marriage to Mr.
Julius Shun C. Nakamura last June 7, 2014 at Balingasag Misamis Oriental.

Employment Data:
1. Previous Name: Michelle Cero Sale
Station: Baliwagan National High School
Address: Waterfall, Balingasag Misamis Oriental
Employee No.: 4730003
Item No.: TCH1-662903-2012

2. Present Name: Michelle Sale Nakamura

Station: Baliwagan National High School
Address: Waterfall, Balingasag Misamis Oriental
Employee No.: 4730003
Item No.: TCH1-662903-2012

Attached is my marriage contract Xerox copy.

Very truly yours,

MICHELLE C. SALE
Teacher I