Republic of the Philippines

Department of Education
REGION VI – Western Visayas
SCHOOLS DIVISION OF SAGAY CITY

Date: August 18, 2023

MARSETTE D. SABBALUCA, CESO VI

Schools Division Superintendent

ATTENTION:

NOE B. ABDON
Administrative Officer V

Dear Ma’am:

I would like to request from your good office a refund of my GSIS (GFAL, Emergency, Computer or other)
for the month of February 2023.

Attached are the photocopy of my Payslip, OR / Certificate of full payment from GSIS, and photocopy of
my valid ID.

I hereby authorize the Cashier of the Division Office to deposit the said claims directly to my LBP payroll
Account 2975045520.

I hope for your immediate action.

Thank you very much.

Sincerely,

LEVI JAMES J. ARELLANO

217-513-6387047
Email: levijames.arellano@deped.gov.ph
LBP ACCOUNT: 2975045520