ANNEX B

LIST OF ACTUAL RETIREES TO BE PAID

Terminal Leave and Retirement Gratuity Benefits
NCA No.______________
Date of Issue__________
LARP Batch No.________
DEPARTMENT:
DEPARTMENT of EDUCATION - National Capital Region ( Division of City Schools, Manila)
Highest
Rank/ Position Unique Position Amount
(Mo/Day/Year) Monthly
NAME Of GSB
(Branch, Salary
Name of retiree/
Address)/Savings Original Retirement
Retirement Date Item Number Birth
Appointment
Retirement
(Per Gratuity
Net Amount DBM Recommendation
Account Number Terminal Leave Total Deduction *if any
NOSA)
Retirement Law

A. Compulsory
Under R.A No.___
(8291, 1616, 660)
1.Fe J. Tabora Through Head Teacher VI OSEC-DECSB-HTEACH6-30099-1998 12/6/1956 6/11/1984 7/6/2020 53,537.00 121,770.049 121,770.049 121,770.049 121,770.049
2. Check
3.
Sub-Total 121,770.049

B. Optional
UnDer R.A. No. ___
(8291, 1616, 660 )
1.
2.
3.
Sub-Total

Grand Total 121,770.049

I hereby warrant that this list containing the names of actual I hereby attest to the veracity and accuracy of the names of the listed retirees and their
retirees to be paid and their corresponding terminal leave benefit corresponding terminal leave benefit claims, as well as the completeness and authenticity of
claims was prepared in accordance w/existing budgeting, accounting the supporting documents submitted by the retirees concerned to this Office.
and auditing rules and regulations.
Approved: Approved:
Certified Correct
MARIA MAGDALENA M. LIM, CESO V WILFREDO E. CABRAL
JOSEPHINE C. LORENZO Schools Division Superintendent Regional Director, DepEd-NCR and RUBY P. MURO
Chief Accountant Officer-in Charge, Office of the Undersecretary

Human Resource and Organizational Development Regional Director

* Deductions shall cover unpaid obligations of retirees covering unpaid loans tovarious government
agencies (such as GSIS, ETC.) and properly accountabilities with the mother agency.

The total deductions shall be netted out from the gross amount of the retirees separation benefits.
 ANNEX B
LIST OF ACTUAL RETIREES TO BE PAID
Terminal Leave and Retirement Gratuity Benefits
NCA No.______________
Date of Issue__________
LARP Batch No.________
DEPARTMENT:
DEPARTMENT of EDUCATION - National Capital Region ( Division of City Schools, Manila)

Highest
Rank/ Position Unique Position Amount
(Mo/Day/Year) Monthly

NAME Of GSB Date

(Branch,
Name of retiree/
Address)/Savings
Salary
Account Number
Original Retirement
Retirement Date Item Number Birth
Appointment
Retirement
(Per Gratuity
Net Amount DBM Recommendation
Terminal Leave Total Deduction *if any
NOSA)

Retirement Law

A. Compulsory
Under R.A No.___
(8291, 1616, 660)
1.Milagros L. Madiclum Through Teacher III OSEC-DECSB-TCH3-32783-1998 11/22/1973 9/6/2000 4/4/2021 28,905.00 37,549.97 37,549.97 37,549.97 37,549.97
2.
3.
Sub-Total 37,549.97

B. Optional
UnDer R.A. No. ___
(8291, 1616, 660 )
1.
2.
3.
Sub-Total

Grand Total 37,549.97

I hereby warrant that this list containing the names of actual
retirees to be paid and their corresponding terminal leave benefit
claims was prepared in accordance w/existing budgeting, accounting
and auditing rules and regulations.
Certified Correct
I hereby attest to the veracity and accuracy of the names of the listed retirees and their
corresponding terminal leave benefit claims, as well as the completeness and authenticity of
the supporting documents submitted by the retirees concerned to this Office.
Approved: Approved:
 MARIA MAGDALENA M. LIM, CESO V WILFREDO E. CABRAL
JOSEPHINE C. LORENZO Schools Division Superintendent Regional Director, DepEd-NCR and RUBY P. MURO
Chief Accountant Officer-in Charge, Office of the Undersecretary
Human Resource and Organizational Development Regional Director
* Deductions shall cover unpaid obligations of retirees covering unpaid loans tovarious government
agencies (such as GSIS, ETC.) and properly accountabilities with the mother agency.

The total deductions shall be netted out from the gross amount of the retirees separation benefits.