Republic of the Philippines

Office of the Barangay Chairman

Barangay Tamogong
Bais City

SERVICE RECORD
Name: JESSAL MARK UTLANG TIMTIM
Date & Place of Birth: January 24, 1994 / Bais City Negros Oriental

This is to certify that the employee named hereinabove actually rendered services in this
Barangay as shown by the service record below, issued by this Office of Barangay and approved
by the Barangay Chairman.

(1) (2) (3) (4) (5)

SERVICE RECORD OF APPOINTMENT OFFICE LEAVE SEPARATION
Inclusive Dates OF
ABSENCE
w/o Pay
From To Designation Status Monthly Place of Date Cause
Pay Assignment
December November SK PERM Brgy. NONE NONE NONE
01, 2010 30, 2013 Kagawad Tamogong
Bais City
Negros
Oriental
xxxxxxxx xxxxxxxxx xxxxxxxxxx xxxxx xxxxxxx xxxxxxxxxx xxxxxxxxx xxxxx xxxxxx

Page 1 of 1

Certified Correct:

_____________________
Hon. Bernaldo L. Amaro
Barangay Chairman
Brgy. Tamogong Bais City
November 6, 2019
Date Accomplished