Date

CERTIFICATION
TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY UNDER OATH that I have beenactually enrolled in ______________________

School

__________________, _________________, _________________________________________.

Address Course

As listed in the enclosed Transcript of Records and that I have earned the units indicated thereon.
As required, the Department of Education has been furnished with authentic copies of the enclosure
in accrdance with the provisions of Department Order No. 12 s. 1962, and enclosure to Memo
no. 51 s. 1962.

(Signature over Printed Name of Teacher)

SUBSCRIBED AND SWORN TO before me this _______ day of _____________________, 20____

at __________________, affiant exhibiting her/his Residence Certificate No. ________________,
issued at ______________________ on ___________________.
 VOLUNTARY UNDERTAKING of APPLICANT

I, ______________________________, of legal age, and a resident of

___________________________________, applicant for reclassification of teacher position,
hereby VOLUNTARILY UNDERTAKE AND UNDERTSTAND, NOT to submit any application for
natural vacancies for teacher positions if my herein application is included in the approved
reclassification of teacher postitions from the Regional Office.
Further, it shall be my responsibility to verify from the proper office wether or not my
herein application is approved to ensure compliance with this voluntary undertaking.
This _____day of _________________20___ at Lagawe, Ifugao Philippines.

Name and Signature of Applicant

 Republic of the Philippines
DEPARTMENT OF EDUCATION
CORDILLERA ADMINISTRATIVE REGION
SCHOOLS DIVISION OFFICE - IFUGAO
Division

EQUIVALENTS RECORD FORM

Name: Date of Birth: Gender:
(Surname) (Given Name) (Middle Name)

Item Number: OSEC-DECSB-TCH__________ Position Title: _____________

School/District: ________________ Monthly Salary: ____________ CP #:_____________
I. EDUCATIONAL ATTAINMENT & CIVIL SERVICE ELIGIBILITY: _______________________________
Degree or Highest Level/ Year Graduated/ Eligibility
Name of Institution Rating Date
Units Earned Period of Attendance (CS Exam/PRC)

II. SERVICE RECORD: (attach duly certified Service Record)

A. Total number of years in teaching: Public: Private: Equivalent:
B. Degree or Degree Equivalent: (present degree) Equivalent:
Period of Equivalent No. of Units Description
C. Areas of Equivalent Attendance/Service
1. Professional study
2. Teaching Experiences
a. Public School
b. Private School

III. SEMINARS, WORKSHOPS, ETC. (attached cps)

TOTAL:
IV. LATEST PERFORMANCE RATING:
Rating Period Rating (Numerical/Descriptive) Teacher's Signature

VERIFIED AND CERTIFIED CORRECT:

Name & Signature of School Head

V. DIVISION ACTION:
Classification Date Grade Assignment Salary Grade Monthly Salary Remarks
Processed

PROCESSED BY: CERTIFIED CORRECT: RECOMMENDING APPROVAL:

BEVERLY B. DAMUGGO JOHN N. GAHID GLORIA B. BUYA-AO

Administrative Officer V Schools Division Superintendent

VI. DepEd-CAR-RO Action:

 DOCUMENTARY REQUIREMENTS FOR THE PROCESSING OF DOCUMENTARY REQUIREMENTS FOR THE PROCESSING OF
RECLASSIFICATION OF POSITION (ERF) RECLASSIFICATION OF POSITION (ERF)

Present Position: _________ Desired Position: __________ Present Position: _________ Desired Position: __________
Name: Name:
School/Dist. School/Dist.

1 EQUIVALENT RECORD FORM (ERF) - 4 COPIES 1 EQUIVALENT RECORD FORM (ERF) - 4 COPIES
ORIGINAL for the teacher ORIGINAL for the teacher
2ND COPY for the Regional Office Record Section 2ND COPY for the Regional Office Record Section
3RD COPY for the Division Office Record Section 3RD COPY for the Division Office Record Section
4TH COPY for the school 4TH COPY for the school

2 ORIGINAL TRANSCRIPT OF RECORDS (OTR) with 3 2 ORIGINAL TRANSCRIPT OF RECORDS (OTR) with 3
photocopies. photocopies.

3 SWORN STATEMENT of the teacher in compliance w/ the 3 SWORN STATEMENT of the teacher in compliance w/ the
provision of DO #12,s.1962, (Inclosure to MEMO. #52,s.1962) provision of DO #12,s.1962, (Inclosure to MEMO. #52,s.1962)
if the Teacher studied in a PRIVATE SCHOOL. (1 COPY) if the Teacher studied in a PRIVATE SCHOOL. (1 COPY)

4 ORIGINAL Copy of approved STUDY LEAVE/PERMIT/SCHOLARSHIP 4 ORIGINAL Copy of approved STUDY LEAVE/PERMIT/SCHOLARSHIP
AGREEMENT. (1 ORIGINAL COPY ) AGREEMENT. (1 ORIGINAL COPY )

5 Certification from the school on the area of SPECIALIZATION 5 Certification from the school on the area of SPECIALIZATION
in the given course STATING the number of units required to in the given course STATING the number of units required to
finish the course including the thesis writing and the number of finish the course including the thesis writing and the number of
LACKING UNITS (1 Original Copy) LACKING UNITS (1 Original Copy)

6 Complete SERVICE RECORD showing inclusive dates of paid 6 Complete SERVICE RECORD showing inclusive dates of paid
service/salary adjustments granted,duly certified by any service/salary adjustments granted,duly certified by any
authorized official. (1 COPY) authorized official. (1 COPY)

7 Latest PERFORMANCE RATINGS w/ at least Very Satisfactory 7 Latest PERFORMANCE RATINGS w/ at least Very Satisfactory
for the least 2 RATING PERIODS (1 COPY each) for the least 2 RATING PERIODS (1 COPY each)

8 Certificate of TRAININGS/SEMINARS of at least 3 DAYS 8 Certificate of TRAININGS/SEMINARS of at least 3 DAYS

(should be continuous) (1 ORIGINAL COPY) (Division level and higher) (should be continuous) (1 ORIGINAL COPY) (Division level and higher)

9 All documents in photocopies should be DULY CERTIFIED 9 All documents in photocopies should be DULY CERTIFIED
BY THE Admin officer or any authorized official/ BY THE Admin officer or any authorized official/
representative. representative.
REQ. FOR MASTER TEACHER POSITION
REQ. FOR MASTER TEACHER POSITION

Name: _____________________ Name: _____________________

Present position: __________ Present position: __________
Desired position: __________ Desired position: __________
Item No. _____________ Mo. Salary: _______ Item No.: _____________Mo. Salary: ________
School/Dist. ________________ School/Dist. ________________

List of teaching positions per district/ List of teaching positions per district/ school
school signed by PSDS/ School Head signed by PSDS/ School Head

Duly accomplished PAL in 2 copies with CD Duly accomplished PAL in 2 copies with CD
DO DO

Certification issued by the SDS that the Certification issued by the SDS that the
teachers listed in the PAL were neither teachers listed in the PAL were neither
promoted/ reclassed/ resigned nor has promoted/ reclassed/ resigned nor has
DO pending request for promotion/ DO pending request for promotion/
reclassification or resignation. reclassification or resignation.

Updated Service Record Updated Service Record

Ranklist of all teachers who are qualified Ranklist of all teachers who are qualified to
to the desired position, duly signed by the the desired position, duly signed by the
Chairman & members of the Ranking Chairman & members of the Ranking
Committee, & attested by the SDS. Committee, & attested by the SDS.
Qualification documents for MT criteria Qualification documents for MT criteria
(per inclosure to DO # 57, s. 1997) (per inclosure to DO # 57, s. 1997)

MASTER TEACHER I MASTER TEACHER I

Permanent Teacher (latest appointment) Permanent Teacher (latest appointment)
VS Performance Rating for the last 2 years VS Performance Rating for the last 2 years
(at least 33 pts.) (IPCR for the last 2 (at least 33 pts.) (IPCR for the last 2 S.Ys.)
S.Ys.)
At least 3 years of experience At least 3 years of experience
At least with 25 pts. In the leadership and At least with 25 pts. In the leadership and
potential or has been a demonstrattion potential or has been a demonstrattion
teacher in the district level with 15 pts. in teacher in the district level with 15 pts. in
leadership and potential. leadership and potential.

MASTER TEACHER II MASTER TEACHER II

MT for atleast 1 year. (appointment) MT for atleast 1 year. (appointment)
VS performance rating for the last 2 years VS performance rating for the last 2 years
( at least 33 pts. As MTI) ( at least 33 pts. As MTI)
(IPCR for last 2 Sys.) (IPCR for last 2 Sys.)

Bachelor's Degree plus completion of Bachelor's Degree plus completion of

academic req'ts. For Master of Arts academic req'ts. For Master of Arts
(Transcript of Record and Certification) (Transcript of Record and Certification)

At least with 30 pts. in leadership and At least with 30 pts. in leadership and
potential or has been a demonstration potential or has been a demonstration
teacher in the division level with 20 pts. in teacher in the division level with 20 pts. in
leadership and potential provided the leadership and potential provided the
activities or accomplishments listed for activities or accomplishments listed for the
the purpose had not been credited or purpose had not been credited or used for
used for earlier promotions. earlier promotions.
 DEPARTMENT OF EDUCATION - CORDILLERA ADMINISTRATIVE REGION
REQUIREMENTS FOR RECLASSIFICATION OF POSITIONS
(Per D.O. 97, s. 2011)

NAME OF APPLICANT: ______________________

Current Position: _________ For reclass to: _________
From SG ______ Step _____ (____________) to SG ______ (___________) Diff.: ____________
School/District/Division: ___________________________
A. Applicants
1 Justification for the reclassification of position
2 Duly accomplished Form 212 (Personal Data Sheet)
3 Certified, Authenticated and Verified (CAV) Transcript of Records
4 Service Records
5 Performance Rating for the last tree (3) consecutive years

6 Certificates/proofs of Outstanding Accomplishments

7 ERF for HT positions; PDF for Principal Positions
NEAP Certification as to the result of the NQEP taken and Basic Training Course for School heads attended; (QEP rating
8 administered by the Region)

SBM Task Force's certification as to the rating obatined in the internal and external stakeholders' assessment (signed
9 by Applicant)

Division Selection and Promotions Board's Certification on the points obtained in the Psychological Attributes and
10 Personality Traits assessment, and ;

11 Enrolment Data (From 3) in the present school assignment, including the cluster schools handled, if any

B. Division Office
12 Copy of the latest PSIPOP where the item is reflected

13 List of teachers under supervision, with the identification of their respective plantilla item number per latest PSIPOP

14 Copy of the latest PSIPOP wherein the names of teachers under supervision are reflected;
15 Certification of non-availability of item.

C. For Principal I Applicants:

16 Passed the NQEP and completed the Basic training course for School Heads as certified by NEAP.

17 Obtained at least 50% of the indicators for internal and external stakeholders as assessed and certified by the Division
sbm Task Force using the SBM assessment tools;
Obtained at least 10 points of the Psychosocial Attributes and Personality Traits as assesses by the Division Selection
18 and Promotions Board

D. HT I-IV and PII-IV Applicants

19 Certification by the NEAP that they have attended the required trainings for the desired position.

20 Trainings attended shall be attested as true and correct by the SDS and shall be submitted to the NEAP thru the RO