Republic of the Philippines

Department of Education
Region VII, Central Visayas
DIVISION OF CEBU CITY

Date

The Regional
Director DepEd,
Region VII
Sudlon, Cebu
City

Sir:

Please DISCONTINUE/ DEDUCT/ ADJUST the deductions being affected from my monthly
salary
effective ______________as indicated hereunder.

( ) Discontinue
Name/ Type of Loan

Amount of Loan

( ) Deduct
Name/ Type of Loan

Amount of Deduction

( ) Adjust From:
What need to be adjusted

To: _____________________________________

Very truly yours,

Name w/ Signature: __________________________________

Division Code: ______
Station Code: ______
Employee Number: ______
GSIS BP Number: ______
HDMF MID Number: ______
Contact Number: ________________