SAMPLE Accomplish in two (2) copies

ONLY
Office/Service/Division/RAB:
TRANSFER OF CUSTODY OF Human Resource Development Division
RECORDS
Date: 16 June 2021
REMINDER: In filling-out this form, please refer to the Agency Records Disposition Schedule/
General Records Disposition Schedule and/or ask guidance from the Records Division
GRDS/RDS RECORDS SERIES TITLE AND DESCRIPTION
PERIOD COVERED
ITEM NO. (indicate if hard copy or electronic copy)
HUMAN RESOURCE/PERSONNEL
MANAGEMENT RECORDS

14 Notices of Overpayments (hard and soft copies) June 2019- March 2020
Allowances
Mr. Juan Dela Cruz
Ms. Juana Dela Cruz
Mr. Pedro Santos
Ms. Petra Santos
Salary
Mr. Juan Dela Cruz
Ms. Juana Dela Cruz
Mr. Pedro Santos
Ms. Petra Santos

15 Promotion & Selection Files (hard copies)

Board Resolution
BR 1 re: Promotion of five employees 07 July 2020
BR 2 re: Application of Mr. Santos 11 August 2020

LOCATION OF RECORDS: VOLUME (e.g., No of boxes/folders/envelopes):

HRDD Storage Room, 6th floor, HLURB Bldg., Quezon 1 box
City
TRANSFERRED BY: RECEIVED BY:

_______ Carlo P. Miranda_______ _______ Jose L. Garcia_______

Signature over Printed Name Signature over Printed Name

The recipient of records shall be held responsible for the following provisions of RA 9470 or The National Archives of the
Philippines Act of 2007:
ARTICLE VI, SECTION 40: A person who, willfully or negligently, damages a public record or disposes of or destroys a public record other than in
accordance with the provisions of this Act or contravenes or fails to comply with any provision of this Act or any regulations made under this Act
shall be deemed to have committed an offense.

ARTICLE VI, SECTION 41: Any public officer committing any of the unlawful acts or omissions mandated under this Act shall be punished by a
fine of not less than P500,000.00 but not exceeding P1M or be imprisoned for not less than 5 years but not more than 15 years and/or both fine
and imprisonment at the discretion of the court without prejudice to the filing of administrative charges that would result to such public officer’s
perpetual disqualification from public office, and forfeiture, in favor of the govt., of his salary and other lawful income.