Republic of the Philippines

Department of Education
Caraga Region
DIVISION OF CABADBARAN CITY

E Q U I V A L E N T R E C O R D F O R M (ERF)
(submit in four copies)

Name: Date of Birth: Sex:

(Surname) (First Name) (M.I.)

Employee Number: __________________________________________ Authorized Position Title: ______________________

Item Number : ______________________________________________ Actual Salary: _________________________________

I. EDUCATIONAL ATTAINMENT AND CIVIL SERVICE ELIGIBILITY

Title, Degree of Year Civil Service
Highest Grade Name of Institution Received Eligibility Rating Date
Attained

II. SERVICE RECORDS (Please attach duly certified service record )

III. EQUIVALENT UNITS
A. Total Number of Years Teaching: Equivalent _____________
B. Degree to Degree Equivalent : (Present Degree) __________________ Equivalent _____________
C. Areas of Equivalent: Inclusive Dates No. of Units Description
1. Professional Study
2. Teaching Experience
a. Public School
b. Private School
3. Administrative Supervisory Experience
a. Public School
b. Private School
4. Others (Seminars, Workshop, etc.)

TOTAL
LATEST EFFICIENCY RATING: ________________
Conforme:

Teacher's Name and Signature School Principal/School Head

Note: Teachers do not write below

IV. DIVISION ACTION

Classification Date Processed Range Salary Range Scheduled Remarks
Assignment Salary

ASSESSED BY: CERTIFIED CORRECT BY: REVIEWED BY: RECOMMENDING APPROVAL:

AMIE ROUZELA P. CORNITES JILL A. MARCELLONES FLORENCE E. ALMADEN, CESO VI JEANIE L. MATIVO, Ph.D., CESO VI
HRMO II Administrative Officer V Asst. Schools Division Superintendent Schools Division Superintendent

IV. REGIONAL OFFICE ACTION

Evaluated by: Certified Correct: Approved:

FE M. BARING MERIAM C. DELA RITA MA. GEMMA M. LEDESMA, CESO V

Teacher Credentials Evaluator II Supervising Administrative Officer Regional Director