Abraham and aysak school inc.

557 Malagasang 1-F Imus, Cavite

(418)-0826

SERVICE RECORD
(To be accomplished by Employer)

NAME: (If married woman, give all full maiden

(Last Name) (Given Name) (Middle Name) name)
BIRTH: (Data herein should be checked from the
(Date) (Place) birth or baptismal certificate or some
other reliable documents.)

This is to certify that the employee named hereinabove actually rendered

services in this office as shown by the record below, each line of which is
supported by appointment and the other papers actually issued by this Office and
approved by the authorities concerned.

SERVICE SEPARATION
RECORD OF APPOINTMENT OFFICE ENTITY/DIV. L/V
(Inclusive Dates) ABS 4
Status Salary Station/Place of Branch W/O
From To Designation PAY Date Cause
1 2 assignment 3

x-x-x-x-x-x NOTHING FOLLOWS -x-x-x-x-x-x

Issued in compliance with Executive Order No. 54 dated August 10, 1954,
and in accordance with Circular No. 58, dated August 10, 1954 of the
system.
CERTIFIED CORRECT:

Chief or Head Office

Date Designation