Region : Region IDivision :

School ID:Name of Office / School :

0

0

Total no. of casual employees:0

To be Encoded Manually

Summary from I.Personal

Total no. of Authorized Positions (per PSI-POP):

Total no. of Filled-up Plantilla Positions:

Total no. of Personnel Re-assigned to:

Total no. of Personnel reassigned from:

Total no. of contractual employees:

Total no. of locally funded employees:

NAME OF PERSONNEL

LAST NAME FIRST NAME

UNIQUE ITEM NUMBER

POSITION TITLE PER PLANTILLA

PARENTHETICAL TITLE

SALARY GRADE

SALARY STEP

NAME OF PERSONNEL

SEX TINMIDDLE NAME NAME EXTENSION

DATE OF BIRTH (MM-DD-YYYY)

DATE OF ORIGINAL

APPOINTMENT (AS NATIONAL) (MM-DD-YYYY)

DATE OF LAST PROMOTION /

APPOINTMENT (MM-DD-YYYY)

EMPLOYMENT STATUS

FUNDING CIVIL STATUS GSIS BP No. SSS No. PLACE OF BIRTH

(TOWN, PROVINCE OR CITY)

Height (m)

Weight (kg)

Blood Type

PAG-IBIG No. (Inc but not

required)

PHILHEALTH No. (Inc but

not required)

Residential Address (Inc but not required)

Region Province / District / City City/ Municipality Barangay Telephone No.Address (House No, Street Name, Village/Subd)

Permanent Address (Required)

Region Province / District / City City / Municipality Barangay Telephone No.Address (House No, Street Name, Village/Subd)

Reassigned From

Reassigned From: School ID

Email Address (preferably

@deped.gov.ph)Cellphone No. (if

any) Reassigned From: Region/ Division/

DistrictLanguages/Dialect

Spoken

NAME RELATIONSHIP LAST NAME(LAST NAME, FIRST NAME MIDDLE NAME NAME EXTENSION)

FIRST NAME MIDDLE NAME FOR CHILD ONLY FOR SPOUSE ONLYDATE OF BIRTH (MM-DD-YYYY) OCCUPATION

FOR SPOUSE ONLYEMPLOYER/BUS. NAME BUSINESS ADDRESS TELEPHONE NO.

EDUCATIONAL BACKGROUNDNAME

(LAST NAME, FIRST NAME MIDDLE NAME NAME EXTENSION)

EDUCATIONAL BACKGROUND

Name of School

INCLUSIVE YEAR

LEVEL From To

EDUCATIONAL BACKGROUND

Course Major MinorYear Graduated

Highest Grade/Level/Units

Earned (if not graduated)

Honors Received

Enter trainings within the last five years starting with the most recent

NAME(LAST NAME, FIRST NAME MIDDLE NAME NAME EXTENSION)

TITLE OF SEMINAR

AREA OF TRAINING INCLUSIVE DATES (MM-DD-YYYY) NO. OF HOURSFROM TO

CONDUCTED BY PLACE OF TRAINING

NAME

(LAST NAME, FIRST NAME MIDDLE NAME NAME EXTENSION)

ELIGIBILITY RATINGDATE OF EXAM/ CONFERMENT (MM-DD-YYYY)

PLACE OF EXAM / CONFERMENT

LICENSE

NUMBER ISSUE DATE (MM-DD-YYYY)

WORK EXPERIENCESNAME INCLUSIVE DATE (MM-DD-YYYY)

(LAST NAME, FIRST NAME MIDDLE NAME NAME EXTENSION) FROM

WORK EXPERIENCESINCLUSIVE DATE (MM-DD-YYYY) POSITION TITLE DEPARTMENT / AGENCY / OFFICE

TOMONTHLY

SALARY

WORK EXPERIENCES

STEP INCREMENTSALARY RANGE/GRADE

STATUS OF APPOINTMENT