Republika ng Pilipinas Kagawaran ng Edukasyon Rehiyon XI SANGAY LUNGSOD NG DABAW Lungsod ng Dabaw SERVICE RECORD (To be accomplished by employer) NAME: BIRTH: LINAZA (Surname) JUNE 8, 1992 (Date) JOEL (Given Name) S. (M.I.) LABISMA, BISLIG CITY (Place) (if married woman, give also full maiden name) (Date herein should be checked from birth or baptismal certificate or some other reliable documents) This is to certify that the employee name herein above actually rendered services in this office as shown by the service record below each line which is supported by appointment and other papers actually issued by this office and approved by the authority SERVICE RECORD OF APPOINTMENT OFFICE ENTITY Leave of Absence Separation Date Station/Place of BRANCH w/o pay Caused From To Designation Status Salary Assignment CERTIFIED AND CORRECT BY: __________________ SCHOOL PRINCIPQAL