Republic of the Philippines

Department of Education
Region No. VIII
ORMOC CITY DIVISION
Ormoc City

CLEAN – UP OF SALARY DEDUCTIONS

Effectivity Termination Amount of
CODE Name of Entity Remarks/Reason for Deletion
Date Date Deduction (Php)

Submitted by: _____________________________

(Signature over printed Name)

Employee No: _____________________ Station: __________________ Date: _________________