A.P.

Guevarra Integrated Schools

FULL NAME JONATHAN V. VILLANUEVA

Residence
# Brgy. St. Malindong
Municipality, Province Binmaley, Pangasinan
School Sabangan Elementary Schools
School Address Municipality, Province Binmaley, Pangasinan
Position T-III
Position Title Teacher III
Salary Grade 13
Salary Step 1
Amount 25, 232
Item Number TOSEC-DECSB-TCH3-61447-2019
Qualification Standard Aliaga NHS

Education : BEED or Bachelors's degree plus 18 Educ. Prof. units

Experience : 2 years relevant experience
Training : None Required
Eligibility : LET, PBET, RA 1080 Teachers
Aloleng Elementary Schools

Amalbalan Elementary Schools

Amanaoac Elementary Schools

Amancosiling Elementary School

Amanperez Elementary Schools

Ambayat Integrated Schools

 ↓ CONTENTS FOR FOLDER 1 ↓ CONTENTS FOR FOLDER 2 ↓ CONTENTS FOR FOLDER 3
1 orig. Letter of Advice 1 copy Registry of Qualified Applicant (RQA) 1 copy Registry of Qualified Applicant (RQA)
1 copy Registry of Qualified Applicant (RQA) c/o DO CS Form 33 (Appointment Form) c/o DO CS Form 33 (Appointment Form)
c/o DO CS Form 33 (Appointment Form) c/o DO Certification of Availability of Funds c/o DO Certification of Availability of Funds
c/o DO Certification of Availability of Funds 1 orig. DBM-CSC Form 1. Position Description Form 1 copy DBM-CSC Form 1. Position Description Form
1 orig. DBM-CSC Form 1. Position Description Form 1 orig. Previous Appointment (for transfer) 1 copy Previous Appointment (for transfer)
1 orig. CS Form 212. Personal Data Sheet 1 orig. CS Form 212. Personal Data Sheet 1 copy CS Form 212. Personal Data Sheet
c/o DO CS Form 32. Oath of Office c/o DO CS Form 32. Oath of Office c/o DO CS Form 32. Oath of Office
1 orig. Authenticated OTR (for Original appt.) 1 orig. Updated Service Record 1 copy Updated Service Record
1 orig. Authenticated PRC License, PRC Rating, Registration 1 orig. Official Transcript of Records 1 copy Official Transcript of Records
1 orig. CS Form 211. Medical Certificate 1 orig. NC & TMC 1 Cert. (for SHS TVL only) 1 copy NC & TMC 1 Cert. (for SHS TVL only)
1 copy Clearances _Brgy. _ Police _NBI (origal appt.) 1 orig. Authenticated PRC License, PRC Rating, Registration 1 copy Authenticated PRC License, PRC Rating, Registration
1 copy Principal's Test Rating (for Principal position) 1 orig. CS Form 211. Medical Certificate (w/results) 1 copy CS Form 211. Medical Certificate (w/results)
1 copy Previous Appointment (for transfer) 1 copy Assets and Liabilities (SALN) 1 copy Assets and Liabilities (SALN)
1 copy Approved ERF (for upgrading of position) 1 orig. Clearances ___Brgy. Police ___NBI 1 copy Clearances ___Brgy. Police ___NBI
1 copy Marriage Certificate / Birth Certificate 1 copy Marriage Certificate / Birth Certificate
1 copy Performance Ratings 1 copy Performance Ratings
1 copy Approved ERF (for upgrading of position) 1 copy Approved ERF (for upgrading of position)
Additional Requirements for transfer Additional Requirements for transfer

1 copy Previous Appointment 1 copy Previous Appointment

1 orig. Certification of Unused service credits, if any 1 copy Certification of Unused service credits, if any
1 orig. Certification of NO pending Administrative 1 copy Certification of NO pending Administrative
1 orig. Clearances from money and property accountabilities 1 copy Clearances from money and property accountabilities
1 orig. Certification of your Actual Last Day of Service 1 copy Certification of your Actual Last Day of Service
1 orig. Updated service records 1 copy Updated service records
1 copy Performance Ratings 1 copy Performance Ratings
BROWN FOLDER BROWN FOLDER BROWN FOLDER

↓ CONTENTS FOR FOLDER 1 ↓ CONTENTS FOR FOLDER 2 ↓ CONTENTS FOR FOLDER 3

1 orig. Letter of Advice 1 copy Registry of Qualified Applicant (RQA) 1 copy Registry of Qualified Applicant (RQA)
1 copy Registry of Qualified Applicant (RQA) c/o DO CS Form 33 (Appointment Form) c/o DO CS Form 33 (Appointment Form)
c/o DO CS Form 33 (Appointment Form) c/o DO Certification of Availability of Funds c/o DO Certification of Availability of Funds
c/o DO Certification of Availability of Funds 1 orig. DBM-CSC Form 1. Position Description Form 1 copy DBM-CSC Form 1. Position Description Form
1 orig. DBM-CSC Form 1. Position Description Form 1 orig. Previous Appointment (for transfer) 1 copy Previous Appointment (for transfer)
1 orig. CS Form 212. Personal Data Sheet 1 orig. CS Form 212. Personal Data Sheet 1 copy CS Form 212. Personal Data Sheet
c/o DO CS Form 32. Oath of Office c/o DO CS Form 32. Oath of Office c/o DO CS Form 32. Oath of Office
1 orig. Authenticated OTR (for Original appt.) 1 orig. Updated Service Record 1 copy Updated Service Record
1 orig. Authenticated PRC License, PRC Rating, Registration 1 orig. Official Transcript of Records (Autheticated) 1 copy Official Transcript of Records
1 orig. CS Form 211. Medical Certificate 1 orig. NC & TMC 1 Cert. (for SHS TVL only) 1 copy NC & TMC 1 Cert. (for SHS TVL only)
1 copy Clearances _Brgy. _ Police _NBI (origal appt.) 1 orig. Authenticated PRC License, PRC Rating, Registration 1 copy Authenticated PRC License, PRC Rating, Registration
1 copy Principal's Test Rating (for Principal position) 1 orig. CS Form 211. Medical Certificate (w/results) 1 copy CS Form 211. Medical Certificate (w/results)
1 copy Previous Appointment (for transfer) 1 copy Assets and Liabilities (SALN) 1 copy Assets and Liabilities (SALN)
1 copy Approved ERF (for upgrading of position) 1 orig. Clearances ___Brgy. __ Police ___NBI 1 copy Clearances ___Brgy. __ Police ___NBI
1 copy Marriage Certificate / Birth Certificate 1 copy Marriage Certificate / Birth Certificate
1 copy Performance Ratings 1 copy Performance Ratings
1 copy Approved ERF (for upgrading of position) 1 copy Approved ERF (for upgrading of position)
Additional Requirements for transfer Additional Requirements for transfer

1 copy Previous Appointment 1 copy Previous Appointment

1 orig. Certification of Unused service credits, if any 1 copy Certification of Unused service credits, if any
1 orig. Certification of NO pending Administrative 1 copy Certification of NO pending Administrative
1 orig. Clearances from money and property accountabilities 1 copy Clearances from money and property accountabilities
Look for Personnel Unit Forms under Downloadable tab 1 orig. Certification of your Actual Last Day of Service 1 copy Certification of your Actual Last Day of Service
http://tiny.cc/sdo1website 1 orig. Updated service records 1 copy Updated service records
BROWN FOLDER BROWN FOLDER BROWN FOLDER
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region I
Schools Division Office I Pangasinan
Alvear St. Lingayen, Pangasinan

OATH OF OFFICE

I, JONATHAN V. VILLANUEVA of

Malindong, Binmaley, Pangasinan having been

appointed to the position of Teacher III hereby

solemnly swear, that I will faithfully discharge to the best of my ability, the duties of

my present position and of all others that I may hereafter hold under the Republic of

the Philippines; that I will bear true faith and allegiance to the same; that I will obey

the laws, legal orders, and decrees promulgated by the duly constituted authorities of

the Republic of the Philippines; and that I impose this obligation upon myself

voluntarily, without mental reservation or purpose of evasion.

SO HELP ME GOD.

JONATHAN V. VILLANUEVA

Government ID:
ID Number :
Date Issued :

Subscribed and sworn to before me this day of

in Lingayen, Pangasinan.
SHEILA MARIE A. PRIMICIAS, CESO VI
Assistant Schools Division Superintendent
Officer-In-Charge
Office of the Schools Division Superintendent
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region I
Schools Division Office I Pangasinan
Alvear St. Lingayen, Pangasinan

CERTIFICATION

The Director
Civil Service Commission
San Fernando City, La Union

SIR / MADAM :

In connection with the proposed appointment of JONATHAN V. VILLANUEVA

T-III of DepED, Schools Division Office I Pangasinan, Lingayen, Pangasinan #N/A
per annum effective UPON APPROVAL in this Office, I hereby certify:

a. a. That
That
thethe funds
funds for position
for the the position are available:
are available:
b. b.That
That position
position has has
beenbeen classified
classified to Grade
by WAPCO
by WAPCO 13 1. Step
to Grade 13 Step 1
P 25, 232 and that the appointee will be assigned the duties attached to
the position:
c. That the provisions of law and rules on promotions, senority and nepotism
have been observed:
d. That there is no pending administrative or criminal case filed against the
proposed appointee:
e. That the provision of CSC Memorandum Circular No. 6, Series of 1967
have been observed.

Very truly yours,

SHEILA MARIE A. PRIMICIAS, CESO VI

Assistant Schools Division Superintendent
Officer-In-Charge
Office of the Schools Division Superintendent

Date
1. If the position had not been classified, the appointment should be sent to WAPCO. If the
position is not covered by the WAPCO plan, there is no need for this certification.
2. In case there is pending administrative or criminal case filed against the person
proposed for appointment, the particulars of the case should be stated.
 1. POSITION TITLE (as approved by authorized agency) with
Republic of the Philippines parenthetical title
POSITION DESCRIPTION FORM
DBM-CSC Form No. 1
)Revised Version No. 1 , s. 2017( Teacher III

2. ITEM NUMBER 3. SALARY GRADE

OSEC-DECS B SG 13-1

4. FOR LOCAL GOVERNMENT POSITION, ENUMERATE GOVERNMENTAL UNIT AND CLASS

Province 1st Class 5th Class

City 2nd Class 6th Class
Municipality 3rd Class Special
4th Class

5. DEPARTMENT, CORPORATION OR AGENCY/ 6. BUREAU OR OFFICE

LOCAL GOVERNMENT

Department of Education ELEMENTARY

7. DEPARTMENT / BRANCH / DIVISION

Schools Division Office - Pangasinan I Sabangan Elementary Schools

9. PRESENT APPROP ACT 10. PREVIOUS APPROP ACT 11. SALARY AUTHORIZED 12. OTHER COMPENSATION

25, 232 P 2,000.00

13. POSITION TITLE OF IMMEDIATE SUPERVISOR 14. POSITION TITLE OF NEXT HIGHER SUPERVISOR

School Principal I Schools Division Superintendent

(if more than seven (7) list only by their item numbers and titles)
POSITION TITLE ITEM NUMBER

16. MACHINE, EQUIPMENT, TOOLS, ETC., USED REGULARLY IN PERFORMANCE OF WORK

17. CONTACTS / CLIENTS / STAKEHOLDERS

17a. Internal Occasional Frequent 17b. External Occasional Frequent
Executive / Managerial General Public
Supervisors Other Agencies
Non-Supervisors Others (Please Specify):
Staff
18. WORKING CONDITION
Office Work ✘ Other/s (Please Specify) Instructional / School-based
Field Work

19. BRIEF DESCRIPTION OF THE GENERAL FUNCTION OF THE UNIT OR SECTION

To provide quality education

Page 8 of 14
20. BRIEF DESCRIPTION OF THE GENERAL FUNCTION OF THE POSITION (Job Summary)

1. Facilitates learning, through functional lesson plans, daily log activities and appropriate, adequate and updated instructional materials (print & non-print);
2. Monitors, assessess and evaluates students' progress;
3. Undertakes activities to improve performance indicators;
4. Maintains updated pupils records;
5. Updates parents on pupils progress regularly;
6. Supervises curricular and co-curricular projects and activities;
7. Counsels and guides pupils;
8. Conducts action research;
9. Maintains cleanliness, safety and upkeep of the classroom;
10. Participates in staff development activities, and utilizes KSA gained from seminars, trainings and scholarships;
11. Maintains harmonious relationship with fellow teachers and other school personnel as well as parents and other stakeholders;
12. Supports activities of governmental and non-governmental organizations;
13. Does related work
21a. Education 21b. Experience 21c. Training 21d. Eligibility

BEED or Bachelors's
degree plus 18 Educ. Prof. 2 years relevant experience None Required LET, PBET, RA 1080 Teachers
units

21e. Core Behavioral Competencies Competency Level

NOT APPLICABLE NOT APPLICABLE

21f. Leadership Competencies Competency Level

NOT APPLICABLE

22. STATEMENT OF DUTIES AND RESPONSIBILITIES (Technical Competencies) Competency Level

Percentage of Working See # 20
Time

n/a

23. ACKNOWLEDGMENT AND ACCEPTANCE:

I have received a copy of this position description. It has been discussed with me and I have freely chosen to comply with
the performance and behavior/conduct expectations contained herein.

JONATHAN V. VILLANUEVA
Employee's Name, Date and Signature School Head, Date and Signature

Page 9 of 14
CS Form No. 4
Series of 2017

Republic of the Philippines ###

DEPARTMENT OF EDUCATION ###
Region I ###
Schools Division Office I Pangasinan
ASSUMPTION TO DUTY
Alvear St. Lingayen, Pangasinan ###

###
Name
Position Title
School
CERTIFICATION OF ASSUMPTION TO DUTY Municipality
Effective Date
Surname
This is to certify that Mr./Ms. JONATHAN V. VILLANUEVA has assumed
the duties and responsibilities as Teacher III of Sabangan Elementary Schools,
Binmaley, Pangasinan effective _________________. Issued Month
Issued In
This certification is issued in connection with the issuance of the appointment
of Mr./Ms. __________________ as Teacher III. ###
###
Done this ____ day of ______________ in Lingayen, Pangasinan. ###
###
###

School Head
(Signature over printed name)

###

###
Date: ###
###

###
###
Attested by: ###
###
###
NELIA C. SANTOS ###
Administrative Officer IV ###
Personnel Unit ###
###
###
###
###
201 file For submission to CSCFO ###
Admin within 30 days from the ###
COA date of assumption of the ###
CSC appointee ###
CS Form No. 211
Revised 2017

MEDICAL CERTIFICATE
(For Employment)

INSTRUCTIONS
a. This medical certificate should be accomplished by a licensed government physician.
b. Attach this certificate to original appointment, transfer and reemployment.
c. The results of the following pre-employment medical/physical/mental examinations
must be attached to this form:
Blood Test
Urinalysis
Chest X-Ray
Drug Test
Psychological Test
Neuro-Psychiatric Examination (if applicable)

FOR THE PROPOSED APPOINTEE

NAME (Last Name, First Name, Name Extension (if any) and Middle Name) AGENCY / ADDRESS

ADDRESS

AGE SEX CIVIL STATUS PROPOSED POSITION

FOR THE LICENSED GOVERNMENT PHYSICIAN

I hereby certify that I have reviewed and evaluated the attached examination results, personally examined the
above named individual and found him/her to be physically and medically £FIT / £UNFIT for employment.
SIGNATURE over PRINTED NAME OF LICENSED GOVERNMENT PHYSICIAN: OTHER INFORMATION ABOUT THE
PROPOSED APPOINTEE

AGENCY/Affiliation of Licensed Government Physician:

LICENSE NO. HEIGHT (M) WEIGHT (KG) BLOOD

Bare Foot Stripped TYPE

OFFICIAL DESIGNATION DATE EXAMINED

VILLANUEVA, JONATHAN V.
VILLANUEVA, JONATHAN V.
VILLANUEVA, JONATHAN V.
V.
V.
V.