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BP 208

LIST OF RETIREES
FOR PAYMENT OF TERMINAL LEAVE AND RETIREMENT GRATUITY BENEFITS
FY 2009
DEPARTMENT: AGENCY:
Mandatory
Optional

TERMINAL LEAVE RETIREMENT GRATUITY


Position at Date (Mo/Day/Year) Highest
NAMES OF RETIREES Ret. Date Monthly No. of Leave Total No. of
Orig. Salary Credits Earned Amount Creditable Gratuity Amount
Birth Appt. Ret. (Per NOSA) VL SL Service Months
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)

PREPARED BY: APPROVED BY: DATE:

PERSONNEL OFFICER HEAD OF OFFICE/AGENCY DAY/MO/YR

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