Republic of the Philippines

Department of Education
REGION III
SCHOOLS DIVISION OF PAMPANGA

(Date)

To whom it may concern:

I, (Name of teacher/applicant), (position), (school and district) would like to authorize

Mr. Dexter E. Pangilinan, Administrative Officer IV of Personnel Section, Division of
Pampanga to act on my behalf, with regard to the authentication and verification of my
transcript of records (TOR) to be used for my promotion. I have enclosed a scanned copy of
my DepEd ID as proof of my consent.

Sincerely,

(Name of teacher and signature)

(School)
(District)

Address: High School Blvd., Brgy. Lourdes, City of San Fernando (P)
Telephone No.: (045) 435-27-28; Email Address: pampanga@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF PAMPANGA

Address: High School Blvd., Brgy. Lourdes, City of San Fernando (P)
Telephone No.: (045) 435-27-28; Email Address: pampanga@deped.gov.ph