In accordance with the TCAA issued by DEPED that requires a DEPED Email between the Division Office and

the
Teacher availing a loan to a private lending institution, this acknowledgment receipt has been issued in absence of
your confirmation online.

CONFIRMATION SLIP

This is to confirm the payroll deduction effectivity of the following who availed Salary Loan in

City Savings Bank dated ________________.

Detail as follows:

Name of Teacher : LEILA R. REYES

School : Burgos National High School
Loan Amount : __________________________
Monthly Amortization : __________________________
Effective Date : __________________________
Termination Date : __________________________

Confirmed as signed below.

Name of DepED Verifier/s:

ERNESTO P. CABUDOY ANGELINA A. BALISALISA ELMA E. RADOVAN

Chief of Office/Principal Treasurer/Disbursing Officer Payroll Master

School: BURGOS NATIONAL HIGH SCHOOL

Division: Pangasinan I

_________________
Date

THE MANAGER
City Savings Bank, Inc.
Alaminos Branch

Sir/Madam:

Please be informed that as validated in our payroll records, the following loan/s you approved can be accommodated
in the APDS:

Principal Amount of Amount of

NO. BORROWER’S NAME Employee Station Code Approved Loan Monthly
No. Amortization
1 LEILA R. REYES
2
3
4
5

Any misrepresentation in the application form of the Borrower verified by the Lender shall not be the liability of the
Verifier:

ERNESTO P. CABUDOY ANGELINA A. BALISALISA ELMA E. RADOVAN

Chief of Office/Principal Treasurer/Disbursing Officer Payroll Master