GSIS FORMS

Type Form Details

FORM A New/re-employed/re-instated

transferred in (member transferred to your agency) and/or

FORM B
transferred out (member was transferred to another agency)

updating of salary (salary increase, step increment, promotion,

FORM C etc.), employment status, employee position, correction of date of
effectivity.

for separation tag (resigned, retired, end of term, dismissed, etc.),

FORM D
LWOP, suspended

for updating of personal profile (name, civil status, contact details,

etc.)

FORM E
RMS
Requirements

Form A and copy of appointment

Form B and copy of appointment

Form C and copy of NOSI/appointment

Form D and death certificate/approved s.o./approved

dismissal etc.

Form E and Colored Scanned Copy of PSA Marriage

Certificate
for change of name and civil status/
Scanned Copy of PSA Birth Certificate for correction
of name/birthday, for separated/married to single
status requests copy of court decision/civil service
S.O.
 GSIS FORM C
Request for Salary Adjustment

Level SECONDARY
School/District BUCANA BUNGLAS NATIONAL HIGH SCHOOL, AJUY
GSIS BP Number 2003899041
Last Name BALBAGUIO
First Name LOWIE
Middle Initial B
Suffix N/A
Date of Birth (mm/dd/yyyy) 01/20/1978
Mobile Number 9638688154
Email Address juan.delacruz@mail.com
Basic Monthly Salary 23877
Salary Grade 14
Step 1
Effectivity Date 06/16/2022
Position HEAD TEACHER I
Status of Employment PERMANENT
Reason SALARY ADJUSTMENT DUE TO PROMOTION

Remarks

Note: Please attach copy of Approved NOSI for Step Increment/Appointment for Promotion

I hereby declare that the details furnished above are true and correct to the best of my knowledge and
belief and I undertake to inform you of any changes therein, immediately.

LOWIE B. BALBAGUIO
Signature over printed name