SERVICE RECORD

(To be Accomplished by the Employer)

NAME: LUCERO JOB DG. __ (If married woman, give also maiden name)
(Surname) (Firstname) (M.I) (Date herein should be checked from Birth or Baptismal
BIRTHDAY: January 13, 1993 Camiling, Tarlac Certificate or some other reliable documents)

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

INCLUSIVE DATES SALARY

POSITION ANNUAL GRADE & STATUS OF GOV'T LEAVE OF
STATION
TITLE SALARY STEP APPOINTMENT SERVICE ABSENCE
W/O PAY
FROM TO INCREMENT

Sta. Rosa
7/1/2014 12/31/2015 Teacher I Integrated 222, 588.00 11-1 Permanent Yes None
School

Sta. Rosa
1/1/2016 12/31/2016 Teacher I Integrated 228, 924.00 11-1 Permanent Yes None
School

Sta. Rosa
1/1/2017 to date Teacher I Integrated 235, 440.00 11-1 Permanent Yes None
School
***NOTHING FOLLOWS***

Issued in compliance with Executive Order No. 54 dated August 10, 1954 and in accordance with
Circular No. 58 dated August 10, 1954 of the system.

Date: 12/20/2016________
Purpose: General Purpose___
PREPARED BY:

JOVITA G. DIZON
Administrative Officer V