Académique Documents
Professionnel Documents
Culture Documents
1. NAME OF EMPLOYEE
(Family Name)
(Given Name)
2. DEPARTMENT, CORPORATION OR
AGENCY/ LOCAL GOVERNMENT UNIT
3. BUREAU OR OFFICE
4. DEPARTMENT/BRANCH/DIVISION
7a. SALARY
AUTHORIZED
ORD. NO.
ITEM NO.
:
:
:
:
ORD. NO.
ITEM NO.
ACTUAL
(Middle Name)
12. FOR LOCAL POSITION, CHECK GOVERNMENTAL UNIT AND UNIT CLASS
Municipal
1st
2nd
City
3rd
4th
Province
5th
6th
7th
13. STATEMENT OF DUTIES AND RESPONSIBILITIES. If more space is needed, please attach additional
sheets.
Percentage of Working
Time
:
:
:
:
:
:
:
:
:
16. NAME, TITLE & POSITION NOS. OF THOSE YOU DIRECTLY SUPERVISE (If more than 7, list only by
their item nos. & position titles.)
18. CONTACTS:
Frequent
General Public
Other Agencies
Supervisors
Managements
Others (Specify)
20. I certify that the above answers are accurate and complete.
Date
Signature of Employee
23a. Indicate the required qualifications by years and kind of education considered in filling up a vacancy for
this position. (Keep the position in mind rather than the qualifications of the present incumbent. This
item should be filled for all position other than teaching.)
Education:
Experience:
23b. Licenses of certificates required to do this work, if any.
24. I hereby certify that the above answers are accurate and complete.
________________
Date
25. APPROVED:
________________
Date
____________________________
Head of Agency
only by
ancy for
ent. This