l\tpuIdir of tilt lllJil~ MACAWARAN He EOUICASYON RegiQn VIL Central Visayas DIVISIONOFBAYAWAN CTIY
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DIVI~-lOfi MeMORANDUM
NO
U"3';;)
$,2017
TO:
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ALL Education Program Supervisors, District Supervisors, School Heads of both Elementary and Secondary Schools Bayawan City and Basay
FROM:
OFELIA R. HERMOSA, CESO V
Schools Division Superintendent
SUBJECT: SCHOOL HEADS, TEACHERS AND DIVISION PERSONNEL 201 FILE for SY 2016- 2017 DATE:
April 19, 2017
1. Please be informed that All School Heads are requested to get the 201 File of their respective teachers at the Administrative Unit and submit the completed documents on or before May 26. 2017 c/o . Administrative/Personnel Unit. Attached is the. table of contents for your reference. Use the New Personal Data Sheet (handwritten or computerized) (CS Form No. 212.. Revised 2017) 2. Submit also your Statement of Assets, Liabilities and Networth on April 30. 2017. (2 copies) 3. Immediate compliance and wide dissemination of this Memorandum is desired.
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OFELIA R. MOSA, CESO v Schools Divisl n super1ntend~
201 FILE
TABLE OF CONTENTS 1. All Appointments (CSC Form 33) 2. Assumption to Duty 3. Oath ofOffice (Panunumpa ng Katungkulan) 4. Personal Data Sheet (CSC Form 212-New Form) 5. Position Description Form 6. ... Certificate_of Eligibilities/Ucenses '~.-
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7. Designation Orders (if Applicable) 8. Statement of Assets, Liabilities and 'Networth 9. Notice of Salary Adjustments/Step Increment-(Divlsion Office)
lO.Medical Certificate (eSC Form 211)
11.NBI Clearance (latest available clearance)
12.School Diplomas and Tra nscript of Records
13.NSO Birth Certificate
14.NSOMarriage Contract
15.Certificate of Leave Balances ( for transferees)
16.Clearance from Property and Money Accountabilities (for transferees)
17.Commendations/Awards (for the pastS years only)
18.Col1tract of Service' (if applicable)
. TO WHOM IT MAY CONCERN:
I hereby certify that I submitted,J!the documents listed above. ~.":.
. Teacher
Noted:
TIC/HT/Principal.
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SIGNATURE
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lolly or aIIlnHy to !heappointIrQ or AICOmmending~,or to!he . Ilhletof. . .. . . personwh9 hss ovei)'litl'Jri"the 0fIIce, : -8ureau.orOepartrilent.wIJere you wllibeapppointed, . . a. within !he third degree?
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llrimt\dlatesiljiWslon
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DYES
DYEs- -'-Doo
·"'tnmhirf!hefollrlhdeilM(fortocalGoVemmenlUnir·C8reerE~)?i
IfYES:.give.~Is:
DYES
DNO
IfYES, give detslls:
DYES
Ii. Have youbeen Criminally chaiged b9f0re' any court?
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NO
If YES, give d4Maj1s: Date FUed:
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N·OYESD NO
1::'36.' ffIMYQU ewt~ conVlCtedorany crime ofVlOlaliOh of anYla'.Yi~ OOlf~"di'Ieg'UIatiOn bY
. snycourtorlJ1bunal?
If YES. give details:
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iI'lG~~r:~-Separated fromi!he~rylq81n soy or!hefolfowjng mode!{~m,lion. ....{j YEs' retlremant d~ from !he rolls, dlsmlssal.-termlnatlon, end 01 term, finished contraclor.p/lasell out If YES; give details: .(aboIltion) in !he public 1)1: private sector?. ..'
ar, '
0'00:
YES DNO
If YES, give details (coun\!y):
D
39. Have you acquired !he status or an i!Mligrant or permanent resident oIsnolhet counlry?
4O'Pu~lp: (1!1.1_JJOl!!I.P~~Act.(Rt.$371}:.(b}M!!gnl!.cada fQl:Djsabled1'elSOnS (Rt.
7277); and (e) Solo Parents Wslfa!e Act or 2000 (RA8972), please:answel" the foI!owJng items: 8.· "Arayouamember 01 any Indigenous group?
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lfYES, please specify:
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b:'Are you 1:1 ptirSOii with diSabirtty'i ,
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Ifyes,.p!eas&specify' 10M!; . Co
Are you s solo parant?
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. DaIelPlac& of Issuance:
.-SUBSCRIBED,ANllSWOR(t to beffjre me this
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completa slalsment pursuant to th8 provisions or: pertinant IIIW$, rulss end $gIllailons 01 !he Republlc It !he .J?hlllpplnas,l.au1IlOriZ&!heagency.h&edlauthorized ri;presen1dVe fp verUlylvalidale the contents ~henlIlL ~. agree Ihet" mlsrepRlSe!lfation i made In this' doculll8lll and Its attaohlnanIs. shall cause !he filing 01 '. adminlstraliv!!lCrjmlnal easels againstme, . .
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