Republic of the Philippines

Department of Education
Region XI
SCHOOL DIVISION OFFICE
of DAVAO del SUR

SERVICE RECORD
( To be accomplished by employer)

NAME : Olivo , Mary Jean Gemino

(Last name) (Given Name) ( Middle Name)

Birth: November 29 , 1996 , Mc.Kinley Sulop Davao del Sur

Date of Birth Place of Birth

This is to certify that the employee named herein above actually rendered services in this office as
shown by the record below , each line of which is supported by appointment and the other papers
actually issued by this Office and approved by the authorities concerned.

SERVICE RECORD OF APPOINTMENT OFFICE/ENTITY/DIVISION Leave of absence REMARKS

w/o pay

(Inclusive Dates ) Deisignation Status (1) Salary (2) Station/Place Branch(3)