SAT/SUN/HOLIDAY

AM PM TOTAL # OF
AM PM WEEKDAYS SAT/SUN/HOLIDAY
IN OUT IN OUT HOURS
7:56 12:00 1:00 6:40 4:04 5:40 9:44 8:00 9
8:18 12:00 1:00 5:44 3:42 4:44 8:26 8:00 8
1:00 8:00 0:00 7:00 7:00 8:00
1:00 8:00 0:00 7:00 7:00 8:00
12:00 1:00 5:00 12:00 4:00 16:00 8:00
12:00 1:00 5:00 12:00 4:00 16:00 8:00
12:00 1:00 5:00 12:00 4:00 16:00 8:00
12:00 1:00 5:00 12:00 4:00 16:00 8:00
12:00 1:00 5:00 12:00 4:00 16:00 8:00
12:00 1:00 5:00 12:00 4:00 16:00 5
7:00 5:01 5:00 7:00 23:59 6:59 5
7:00 5:01 5:00 7:00 23:59 6:59 5
7:00 5:01 5:00 7:00 23:59 6:59
7:00 5:01 5:00 7:00 23:59 6:59

WEEKDAYS
AM PM TOTAL # OF
1st Cut 2nd Cut WEEKDAYS WEEKDAYS
IN OUT IN OUT HOURS
5:00 8:00 0:00 3:00 3:00 8 8:00
5:00 8:00 0:00 3:00 3:00 8 8:00
9:00 10:54 0:00 1:54 1:54 10 8:00
18:00 20:00 9:00 12:00 2:00 3:00 5:00 12 8:00 5
8:00 9:00 12:00 8:00 3:00 11:00 12 8:00
8:00 9:00 12:00 8:00 3:00 11:00 12 8:00
8:00 9:00 12:00 8:00 3:00 11:00 12 8:00
8:00 9:00 12:00 8:00 3:00 11:00 12 8:00
8:00 9:00 12:00 8:00 3:00 11:00 12 8:00
8:00 9:00 12:00 8:00 3:00 11:00 12 8:00
SAT/SUN/HOLIDAY

44
26

WEEKDAYS

0
 Annex B

DSWD-GF-010 | REV 01 | 17 AUG 2022

Republic of the Philippines

DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
Magnolia St., PBN Buraguis Legazpi City

STATEMENT OF OVERTIME SERVICES RENDERED

Month/s: 2022

REGULAR WORKING DAYS SATURDAYS/SUNDAYS/HOLIDAYS

AM PM NO. OF NO. OF AM PM NO. OF NO. OF
DATE DATE
IN OUT IN OUT HOURS MINUTES IN OUT IN OUT HOURS MINUTES

02/27/23 7:47 12:02 12:17 8:00 3 7:56 12:00 0:09 6:40 9 44

8:18 12:02 0:31 5:44 8 26

Sub-Total 3 0 Sub-Total 17 70
TOTAL 3 0 TOTAL 18 10
125% 150%
Rate/Hour: 82.20 X 3 125% 308.25 Rate/Hour 82.20 X 18 150% 2,219.40

Rate/Min.: 1.37 X 0 125% 0.00 Rate/Min.: 1.37 X 10 150% 20.55

Salary/Mo.: 14,468.00 TOTAL 308.25 Salary/Mo. 14,468.00 TOTAL 2,239.95

GRAND TOTAL 2,548.20

SIGNATURE OVER PRINTED NAME/POSITION

APPROVED FOR PAYMENT in the amount of PHP 2,548.20 , the above expenses having been incurred
under my authority in the interest of public service and the charge being just and reasonable, as verily believable.

SIGNATURE OVER PRINTED NAME OF SUPERVISOR

POSITION, OFFICE

PAGE 1 of __
DSWD Field Office V, Regional Center Site, Rawis, Legazpi City, Philippines 4500
Website: https://fo5.dswd.gov.ph/ Email: fo5@dswd.gov.ph
INPUT SG AND SI: 2-7

1.166666667 1 60
0 0 0
 Annex B

DSWD-GF-010 | REV 01 | 17 AUG 2022

Republic of the Philippines

DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
Magnolia St., PBN Buraguis Legazpi City

STATEMENT OF EXTRA SERVICES RENDERED

Month/s: February 2023

REGULAR WORKING DAYS SATURDAYS/SUNDAYS/HOLIDAYS

AM PM NO. OF NO. OF AM PM NO. OF NO. OF
DATE DATE
IN OUT IN OUT HOURS MINUTES IN OUT IN OUT HOURS MINUTES

02/27/23 7:47 12:02 12:17 8:00 3 7:56 12:00 0:09 6:40 9 44

8:18 12:02 0:31 5:44 8 26

Sub-Total 3 0 Sub-Total 17 70
TOTAL 3 0 TOTAL 18 10
125% 150%
Rate/Hour: 97.25 X 3 125% 364.69 Rate/Hour 97.25 X 18 150% 2,625.75

Rate/Min.: 1.62 X 0 125% 0.00 Rate/Min.: 1.62 X 10 150% 24.30

Salary/Mo.: 17,116.55 TOTAL 364.69 Salary/Mo. 17,116.55 TOTAL 2,650.05

GRAND TOTAL 3,014.74

JESSA M. APUYAN / AAIDE IV

APPROVED FOR PAYMENT in the amount of PHP 3,014.74 , the above expenses having been incurred
under my authority in the interest of public service and the charge being just and reasonable, as verily believable.

VICTORIA C. TAGUM
PSD CHIEF / SWO V

PAGE 1 of __
DSWD Field Office V, Regional Center Site, Rawis, Legazpi City, Philippines 4500
Website: https://fo5.dswd.gov.ph/ Email: fo5@dswd.gov.ph
INPUT SG: 4

1.16666666667 1 60
0 0 0
 ANNEX C

DSWD-GF-010 | REV 01 | 17 AUG 2022

STATEMENT OF SPECIFIC WORK ACCOMPLISHMENT DURING OVERTIME

For the Period FEBRUARY 18 to 27, 2023

Authorized to claim for

Date Time Duration REMARKS
Specific Work (please select one)
DAY OF THE Accomplished OT PAY
DAY FROM TO OT PAY COC
WEEK and COC
Encoded client's
information for financial
18-Feb-23 Saturday 7:56 AM 6:40 PM assistance (back logs
onsite)

Encoded client's
information for financial
25-Feb-23 Saturday 8:18 AM 5:44 PM assistance (back logs
onsite)

Asisted in checking
27-Feb-23 Monday 7:47 AM 8:00 PM requirements in CE (onsite
and offsite)

Accomplished by:

____________________________
JESSA M. APUYAN / AAIDE IV
Office: CRISIS INTERVENTION SECTION

The above having been incurred under my authority in the interest of the public service and the charge being just and reasonable, as verify believable.

The monetary compensation requested, cannot be compensated through COC because the availment thereof will adversely affect the operations of
O/B/S/SP/FO

_____________________________________________
VICTORIA C TAGUM
PSD CHIEF / SWO V, OFFICE

Legend:
Date = specific date/day when a particular overtime service was rendered
Time = duration of extra service during the day, indicating the start/end of OT Service
Specific work Accomplished = situation/ work load that give rise to extra service
Immediate Supervisor = should be Division Chief/Designated Division Chief or equivalent level and above

Note: Certifying Officer should have direct knowledge of the specific work cited and shall be administratively liable for any misrepresentation.
 PAGE 1 of __

DSWD Field Office V, Regional Center Site, Rawis, Legazpi City, Philippines 4500
Website: https://fo5.dswd.gov.ph/ Email: fo5@dswd.gov.ph