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Republika ng Pilipinas

KAGAWARAN NG EDUKASYON
Rehiyon XI
SANGAY NG LUNGSOD NG DABAW
Lungsod ng Dabaw

Explanation for Failure to Log-in/out Form (EFLF)


Date:
______________
To: THE SCHOOLS DIVISION SUPERINTENDENT

Pursuant to Division Order 0255, s. 2013, please be informed that I ISADORA A. LATIADA

failed to Log- In ( ) Actual time of Arrival: __________ A.M. ____________P.M.


Date:___________
failed to Log-out ( ) Actual time of Departure: _______ A.M. ____________P.M. Date:
__________
for the following reasons:
___________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
____________
(Use separate sheet if necessary)
ISADORA A.LATIADA
Employee’s Signature over Printed Name

Witnesses: _________________________ _____________________________

Grade Level Head/Year Level Coordinator: _____________________________


__________________________________________________________________________________
___
Action Taken:
__________________________________________________________________________________
___

Attested to employee’s 1st / 2nd time within the


presence in the office on semester excused
the said date/time
____ times within this
Reason cited found valid semester and subject to

Action taken: ___________________________


Reason cited not valid

Recommending Approval: Approved by:

AZENITH R. ANDREE JOBERTH A. SABANAL


Teacher I School Head
Elementary: School head Elementary: District Supervisor
Secondary : Department Head Secondary : School Head
Division Office : Section Chief Division Office: A.O/ASDS/SDS

Notary public:

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