CS Form No.

4
Revised 2018

Republic of the Philippines

Province of Agusan del Sur
Governor Democrito O. Plaza, Government Center, Prosperidad

CERTIFICATION OF ASSUMPTION TO DUTY

This is to certify that Ms./Mr. Jevalee G. Magadan has assumed the

duties and responsibilities as Nurse I (Casual) of Loreto District Hospital
effective August 16, 2023 .

This certification is issued in connection with the issuance of the

appointment of Ms./Mr. Jevalee G. Magadan as Nurse I (Casual) .

Done this 16th day of August 2023 in

Provincial Government of Agusan del Sur
.

MA. ALMA P. BERNARDO, MD

Head of Office/Department/Unit

Date: August 16, 2023

Attested by:

LORNA U. ANCAY
HRMO

201 file
Admin
COA
CSC For submission to CSC FO
within 30 days from the
date of assumption of the
appointee