RPSU FORM 103, REVISED 2021

NOTICE OF STATION TRANSFER

Date: _________________________

EMPLOYEE NUMBER:
EMPLOYEE NAME:

SIGNATURE:

OLD STATION:

DIVISION CODE DIVISION NAME STATION CODE STATION NAME

NEW STATION:

DIVISION CODE DIVISION NAME STATION CODE STATION NAME

First Day of Service in the New Station:

Month (mm) Day (dd) Year (yyyy)

Last Salary Received from the Previous Station:

Month (mm) Day (dd) Year (yyyy)

Please attach herewith the following supporting documents:

1. Division Order from the Schools Division Superintendent

2. First Day of Service signed by the Principal or District Supervisor of the New Station
3. Latest Payslip

Submitted by:

__________________________________
Division Administrative Officer
Agency Authorized Officer
(signature over printed name)
 RPSU FORM 101, REVISED 2021

NOTICE OF PROMOTION

Date: __________________________

DIVISION CODE/NAME:
STATION CODE/NAME:
EMPLOYEE NUMBER:
EMPLOYEE NAME:

SIGNATURE:

OLD POSITION:

NAME OF POSITION POSITION CODE BASIC SALARY GRADE STEP (1-8)

NEW POSITION:

NAME OF POSITION POSITION CODE BASIC SALARY GRADE STEP (1-8)

Please attach herewith the following supporting documents:

Reclassification of ‘ERF’:
1. One certified photocopy of new Appointment (clear copy)
2. Notice of Organization, Staffing and Compensation Advice (NOSCA)
3. GSIS Agency Remittance Advice (ARA) - Form C: Salary Adjustment
4. Certification of savings from the Accountant

Natural Vacancy:
1. One certified photocopy of new Appointment (clear copy)
2. One Certified photocopy of Plantilla from DBM.
3. GSIS Agency Remittance Advice (ARA) - Form C: Salary Adjustment
4. Certification of savings from the Accountant

Submitted by:

__________________________________
Division Administrative Officer
Agency Authorized Officer
(signature over printed name)
 RPSU FORM 104, REVISED 2021

NOTICE OF CHANGED NAME

Date: __________________________

DIVISION CODE/NAME:
STATION CODE/NAME:
EMPLOYEE NUMBER:
EMPLOYEE NAME:

SIGNATURE:

OLD NAME:

FIRST NAME MIDDLE NAME LAST NAME

NEW NAME:

FIRST NAME MIDDLE NAME LAST NAME

Please attach herewith the following supporting documents:

1. One certified photocopy of Marriage Certificate

2. BIR Taxpayer’s Record Update (BIR Form 2305)
3. Certificate of correction of name with Civil Service Resolution if the name that appears
in the Appointment does not match with other records.
4. Division Special Order/Court Decision for Change of Name and status from
marriage to single
5. GSIS Agency Remittance Advice (ARA) - Form E: Changes in Personal Data

Submitted by:

__________________________________
Division Administrative Officer
Agency Authorized Officer
(signature over printed name)
 RPSU FORM 100, REVISED 2021

REQUEST FOR INCLUSION IN THE RPSU ROSTER

(New Teacher/Employee)

COMPLETE NAME: ___________________ ______________________ _______________________________

(First Name) (Middle Name) (Last Name) (Suffix)
Date of Birth: Civil Status: Sex:
Division Name: GSIS BP No.:
Philhealth No.: BIR T.I.N.:
HDMF No.: ATM Account No:

ATTACHED WORKING PAPER/REQUIREMENTS:

1. Certified photocopy of Appointment

2. Last voucher/payrolls paid by the school or division/
Certification of last payment by the school or division
3. Certified photocopy of duly signed Personal Services Itemization
and Plantilla of Personnel (PSIPOP)
4. Previous Appointment, if any, to prove continuous service for payment
of bonuses and computation or payment of Proportional Vacation Pay (PVP)
5. GSIS Agency Remittance Advice (ARA)- Form B: Transfer of Office
6. BIR Form 2305 or photocopy of BIR Identification Card
7. PHILHEALTH Member’s Data Record (MDR)
8. HDMF Identification Card
9. Photocopy of Official Servicing Bank slip bearing the Account No.
10. List of Outstanding Loans PLIs & GLIs form former School or Division

Submitted by:

__________________________________
Division Administrative Officer
Agency Authorized Officer
(signature over printed name)

To be filled by RPSU Staff:

Division Code
Station Code
Employee Number
Position Code
Step Increment (1-8)
 RPSU FORM 102, REVISED 2021

NOTICE OF STEP INCREMENT

Date: __________________________

DIVISION CODE/NAME:
STATION CODE/NAME:
EMPLOYEE NUMBER:
EMPLOYEE NAME:

SIGNATURE:

OLD STEP INCREMENT:

POSITION BASIC SALARY GRADE STEP DATE OF EFFECTIVITY

NEW STEP INCREMENT:

POSITION BASIC SALARY GRADE STEP DATE OF EFFECTIVITY

Please attach herewith the following supporting documents:

1. Updated Notice of Step Increment (NOSI)
2. Latest PLANTILLA of Personnel (PSIPOP)
3. Updated Service Record, if under Special Step Increment, indicate the Executive Order
4. GSIS Agency Remittance Advice (ARA) - Form C: Salary Adjustment
5. Certified photocopy of latest Payslip

SALARY STEP STEP STEP STEP STEP STEP STEP STEP

GRADE 1 2 3 4 5 6 7 8
1 12,034.00 12,134.00 12,236.00 12,339.00 12,442.00 12,545.00 12,651.00 12,756.00
2 12,790.00 12,888.00 12,987.00 13,087.00 13,187.00 13,288.00 13,390.00 13,493.00
3 13,572.00 13,677.00 13,781.00 13,888.00 13,995.00 14,101.00 14,210.00 14,319.00
4 14,400.00 14,511.00 14,622.00 14,735.00 14,848.00 14,961.00 15,077.00 15,192.00
5 15,275.00 15,393.00 15,511.00 15,630.00 15,750.00 15,871.00 15,993.00 16,115.00
6 16,200.00 16,325.00 16,450.00 16,577.00 16,704.00 16,832.00 16,962.00 17,092.00
7 17,179.00 17,311.00 17,444.00 17,578.00 17,713.00 17,849.00 17,985.00 18,124.00
8 18,251.00 18,417.00 18,583.00 18,751.00 18,920.00 19,091.00 19,264.00 19,438.00
9 19,593.00 19,757.00 19,922.00 20,089.00 20,257.00 20,426.00 20,597.00 20,769.00
10 21,205.00 21,382.00 21,561.00 21,741.00 21,923.00 22,106.00 22,291.00 22,477.00
11 23,877.00 24,161.00 24,450.00 24,742.00 25,038.00 25,339.00 25,643.00 25,952.00
12 26,052.00 26,336.00 26,624.00 26,915.00 27,210.00 27,509.00 27,811.00 28,117.00
13 28,276.00 28,589.00 28,905.00 29,225.00 29,550.00 29,878.00 30,210.00 30,547.00
14 30,799.00 31,143.00 31,491.00 31,844.00 32,200.00 32,561.00 32,927.00 33,297.00
15 33,575.00 33,953.00 34,336.00 34,724.00 35,116.00 35,513.00 35,915.00 36,323.00
16 36,628.00 37,044.00 37,465.00 38,891.00 38,323.00 38,760.00 39,203.00 39,650.00
17 39,986.00 40,444.00 40,907.00 41,376.00 41,851.00 42,332.00 42,818.00 43,311.00
18 43,681.00 44,184.00 44,694.00 45,209.00 45,732.00 46,261.00 46,796.00 47,338.00
19 48,313.00 49,052.00 49,803.00 50,566.00 51,342.00 52,130.00 52,932.00 53,746.00
20 54,251.00 55,085.00 55,934.00 56,796.00 57,673.00 58,564.00 59,469.00 60,389.00
21 60,901.00 61,844.00 62,803.00 63,777.00 64,768.00 65,774.00 66,797.00 67,837.00
22 68,415.00 69,481.00 70,565.00 71,666.00 72,785.00 73,923.00 75,079.00 76,253.00
23 76,907.00 78,111.00 79,336.00 80,583.00 81,899.00 83,235.00 84,594.00 85,975.00
24 86,742.00 88,158.00 89,597.00 91,059.00 92,545.00 94,057.00 95,592.00 97,152.00
25 98,886.00 100,500.00 102,140.00 103,808.00 105,502.00 107,224.00 108,974.00 110,753.00
 26 111,742.00 113,565.00 115,419.00 117,303.00 119,217.00 121,163.00 123,140.00 125,150.00
27 126,267.00 128,329.00 130,423.00 132,552.00 134,715.00 136,914.00 139,149.00 141,420.00
28 142,683.00 145,011.00 147,378.00 149,784.00 152,228.00 154,714.00 157,239.00 159,804.00

Submitted by:

__________________________________
Division Administrative Officer
Agency Authorized Officer
(signature over printed name)

RPSU FORM 105, REVISED 2021

REQUEST FOR RPSU CLEARANCE

(For Retirement, Transfer and Resignation)

Date: __________________________

DIVISION CODE/NAME:
STATION CODE/NAME:
EMPLOYEE NUMBER:
EMPLOYEE NAME:

SIGNATURE:

Date of Last Salary Received:

Please attach herewith the following supporting documents:

1. Application for retirement/approved resignation letter of transfer

2. Service Record (duly signed)
3. School/Division Clearance
4. Certification of no obligation from Private Lending Institutions (PLIs) or
Official Receipts of full payment for existing loans
5. Certified photocopy of latest payslip or the original
6. For deceased, attached Birth Certificate/Death Certificate
7. Payslip of Last Salary Received

RPSU Remarks:

______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
 RPSU FORM 106, REVISED 2021

REQUEST FOR DELETION OF DEDUCTION

Date: November 28, 2022

DIVISION CODE/NAME: 139 SURIGAO CITY

STATION CODE/NAME: 010 DISTRICT X
EMPLOYEE NUMBER: 6286833
EMPLOYEE NAME: JESHA F. ABARCA

SIGNATURE:

Deduction Code: 0132

Deduction Name: Consolidated Loan

Policy Number: BP #:2005021257

Amount of Deduction: 1329.68

Date of Deduction Started: MAY 2019

Reason for Deletion: FULLY PAID

Please attach herewith the following supporting documents:

1. Certification of Full Payment or No Obligation from the Private Lending Institutions (PLIs)
2. Certified photocopy of Official Receipt (O.R.) with notation of full payment
3. Stamp received/approved by the GLIs/PLIs concerned on the space provided below
4. Attached latest Payslip
 (Stamp received by concerned company)

RPSU FORM 107, REVISED 2021

REQUEST FOR ADDITION OF DEDUCTION

Date: __________________________

DIVISION CODE/NAME:
STATION CODE/NAME:
EMPLOYEE NUMBER:
EMPLOYEE NAME:

SIGNATURE:

Deduction Deduction Policy Deduction Effectivity Termination

Code Name Number Amount Date Date

List of Deductions:

Deduction Code Deduction Name

0007 Deped Provident Fund
0002A Pagibig Personal Share - Additional
0222C Pagibig MP2
0332 Pagibig Housing Loan
0384 Pagibig Calamity Loan
0336 Pagibig Multi-Purpose Loan
0001 GSIS Policy Loan
0031 GSIS Real State Loan
0132 GSIS Consolidated Loan
0704 GSIS Emergency Loan
1225 GSIS Financial Assistance Loan
1252 GSIS Multi-Purpose Loan
1256 GSIS Computer Loan

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