Republic of the Philippines

Province of Surigao del Norte

Municipality of Placer

RURAL HEALTH UNIT

LGU: Placer, Surigao del Norte Period: FEBRUARY 1-28, 2021

No. Name Designation No. of Honorarium Per Total Signature/

days Month Thumbmark
1. ARGUELLES, APPLE E. NDP 28 days 1,000 X 1 month 1,000.00
2. CAMARIN, RISHA ANN A. NDP 28 days 1,000 X 1 month 1,000.00
3. BARCOS, WILCHEEN C. NDP 28 days 1,000 X 1 month 1,000.00
4. UNGUI, KAREN A. NDP 28 days 1,000 X 1 month 1,000.00
5. GALVEZ, CHARITO D. RHMPP 28 days 1,000 X 1 month 1,000.00
6. MORENO, JULIETA R. RHMPP 28 days 1,000 X 1 month 1,000.00
7. ELIMANCO, JEZREL MAE S. NDP 28 days 1,000 X 1 month 1,000.00
8. JAMER, RENIE M. NDP 28 days 1,000 X 1 month 1,000.00
9. GUHITING, VALERIE A. NDP 28days 1,000 X 1 month 1,000.00
10. SANDIGAN, RHIZA MARIE E NDP 28 days 1,000 X 1 month 1,000.00
11. RODRIGUEZ, KRISTENA NDP 28 days 1,000 X 1 month 1,000.00
KARREN G.
12. CAGAS, FEA TEEPFANEZ R. NDP 28 days 1,000 X 1 month 1,000.00
13. DOVERTE, ROUELLA A. NDP 28 days 1,000 X 1 month 1,000.00
14. CUTAMORA, CANDY C. NDP 28 days 1,000 X 1 month 1,000.00
15. TUMBAGA, BEVERLY GRACE L. NDP 28 days 1,000 X 1 month 1,000.00
16. DRAMAYO, APRIL T. RHMPP 28 days 1,000 X 1 month 1,000.00
17. OCAMPO, APPLE L. NDP 28 days 1,000 X 1 month 1,000.00
18. APA, CARESAGIN V. NDP 28 days 1,000 X 1 month 1,000.00

I HEREBY certify that above persons had rendered services during Monday and Friday.

CERTIFIED: APPROVED PAYMENTS: CERTIFIED:

Each person whose name appears on Each person whose name appears on
this roll had rendered services for the this roll had rendered services for the
stated. stated.

RACHELLE JEAN O. SANCHEZ, RN, MD. JOVYMARIE C. VILLAZON DELIA G. MORALES

Municipal Health Officer Municipal Mayor Acting Municipal Treasurer
 Republic of the Philippines
Province of Surigao del Norte
Municipality of Placer

RURAL HEALTH UNIT

C-E-R-T-I-F-I-C-A-T-I-O-N
TO WHOM IT MAY CONCERN:

We hereby certify that we are responsible in declaring our monthly honorarium received from
Local Government Unit of Placer Surigao del Norte as Nurse, Midwives under the Human Resource for
Health (HRH), Rural Health Midwives Placement Program (RHMPP) for the month of SEPTEMBER 01-30
in our Annual Income Tax Return the year 2021.

Issued this ______ day of OCTOBER 2021 at Placer, Surigao del Norte.

NAME TIN NUMBER DESIGNATION SIGNATURE

ARGUELLES, APPLE E. 448-149-664-000 NDP
CAMARIN, RISHA ANN A. 488-312-767-000 NDP
DOVERTE, ROUELLA A. 448-149-973-000 NDP
BARCOS, WILCHEEN C. 310-911-312-000 NDP
UNGUI, KAREN A. 433-636-657-000 NDP
GALVEZ, CHARITO D. 403-097-863-000 RHMPP
MORENO, JULIETA R. 925-558-412-000 RHMPP
ELIMANCO, JEZREL MAE S. 488-216-161-000 NDP
JAMER, RENIE M. 309-842-593-000 NDP
GUHITING, VALERIE A. 316-113-702-000 NDP
SANDIGAN, RHIZA MARIE E. 315-730-169-000 NDP
RODRIGUEZ, KRISTENA KARREN G. 420-076-802-000 NDP
CAGAS, FEA TEEPFANEZ R. 950-562-431-000 NDP
CUTAMORA, CANDY C. 405-988-817-000 NDP
TUMBAGA, BEVERLY GRACE L. 480-814-986-000 NDP
DRAMAYO, APRIL T. 721-782-180-000 RHMPP
OCAMPO, APPLE L. 470-616-215-000 NDP
APA, CARESAGIN V. 462-603-610-000 NDP

NOTED BY

RACHELLE JEAN O. SANCHEZ, RN, MD.

Municipal Health Officer
 Republic of the Philippines
Province of Surigao del Norte
Municipality of Placer

RURAL HEALTH UNIT

LGU: Placer, Surigao del Norte Period: FEBRUARY 1-28, 2021

No. Name Designation No. of Honorarium Total Signature/
days Per month Thumbmark

1. AFINIDAD, CEEJAY A. MTDP 28 days 2,000.00 x 1 2,000.00

month

I HEREBY certify that above person had rendered services during Monday to Friday.

CERTIFIED: APPROVED PAYMENTS: CERTIFIED:

Each person whose name appears on Each person whose name

this roll had rendered services for the appears on this roll had
stated. rendered services for the
stated.

RACHELLE JEAN O. SANCHEZ, RN, MD. JOVYMARIE C. VILLAZON DELIA G. MORALES

Municipal Health Officer Municipal Mayor Acting Municipal Treasurer
 Republic of the Philippines
Province of Surigao del Norte
Municipality of Placer

RURAL HEALTH UNIT

C-E-R-T-I-F-I-C-A-T-I-O-N
TO WHOM IT MAY CONCERN:

I hereby certify that I am responsible in declaring my monthly honorarium received in the

amount of two thousand pesos per month (P2,000) from Local Government Unit of Placer Surigao del
Norte as Medical Technologist under the Medical Technologist Deployment Program (MTDP), for the
month of MARCH to APRIL 2022 in my Annual Income Tax Return.

Issued this _______ day of MAY 2022 at Placer, Surigao del Norte.

NAME TIN NUMBER DESIGNATION SIGNATURE

DIANARA CHARRY A. BADATO 476-898-720-000 MTDP

NOTED BY:

RACHELLE JEAN O. SANCHEZ, RN, MD.

Municipal Health Officer
 Republic of the Philippines
Province of Surigao del Norte
Municipality of Placer

RURAL HEALTH UNIT

C-E-R-T-I-F-I-C-A-T-I-O-N
TO WHOM IT MAY CONCERN:

We hereby certify that we are responsible in declaring our monthly honorarium received in the
amount of One thousand pesos per month (P1,000) from Local Government Unit of Placer Surigao del
Norte as COVID-19 VACCINATORS for the month of MAY TO JULY 2021 in our Annual Income Tax
Return.

Issued this _______ day of AUGUST 2021 at Placer, Surigao del Norte.

NAME TIN NUMBER DESIGNATION SIGNATURE

RANIBETH G. PADALAPAT 737-311-707-000 VACCINATOR

MARCHIE G. BESIN 934-161-285-000 VACCINATOR

NOTED BY:

RACHELLE JEAN O. SANCHEZ, RN, MD.

Municipal Health Officer
 Republic of the Philippines
Province of Surigao del Norte
Municipality of Placer

RURAL HEALTH UNIT

C-E-R-T-I-F-I-C-A-T-I-O-N
TO WHOM IT MAY CONCERN:

I hereby certify that I am responsible in declaring my monthly honorarium received in the

amount of One thousand pesos per month (P1,000) from Local Government Unit of Placer Surigao del
Norte as HEALTH PROGRAM OFFICER for the month of JUNE TO JULY 2021 in my Annual Income Tax
Return.

Issued this _______ day of AUGUST 2021 at Placer, Surigao del Norte.

NAME TIN NUMBER DESIGNATION SIGNATURE

HEALTH
DIANA CARLA L. MISAGAL 943-022-792-000 PROGRAM
OFFICER

NOTED BY:

RACHELLE JEAN O. SANCHEZ, RN, MD.

Municipal Health Officer
 Republic of the Philippines
Province of Surigao del Norte
Municipality of Placer

RURAL HEALTH UNIT

C-E-R-T-I-F-I-C-A-T-I-O-N
TO WHOM IT MAY CONCERN:

I hereby certify that I am responsible in declaring my monthly honorarium received in the

amount of Two thousand pesos per month (P2,000) from Local Government Unit of Placer Surigao del
Norte as a DENTIST-II under the DENTIST DEPLOYMENT PROGRAM, for the month of January to March
2022 in my Annual Income Tax Return.

Issued this _______ day of APRIL 2022 at Placer, Surigao del Norte.

NAME TIN NUMBER DESIGNATION SIGNATURE

FATIMA ZAHRAH T. YUSOPH 400-201-249-000 DENTIST-II

NOTED BY:

RACHELLE JEAN O. SANCHEZ, RN, MD.

Municipal Health Officer