Enclosure to Department Memorandum No.

140 s, 1976

Republic of the Philippines

DEPARTMENT OF EDUCATION
CARAGA ADMINISTRATIVE REGION
Division of Surigaodel Sur
Tandag City

EQUIVALENT RECORD FORM (ERF)

MOLLANEDA , MARY-ANN M.
Name: ___________________________________________ July 29, 1984
Date of Birth: ________________Sex: Female
_______
C. (Surname) (Given Name) (M.I.)
Employee No.: ____________________________________
4238034 Authorized Position Title: _________________
TEACHER - I
Item Number: ____________________________________
TCH1-1020115-2002 Actual Salary: ___________________________
21,327.00
I. EDUCATIONAL ATTAINMENT AND CIVIL SERVICE ELIGIBILITY:

Titles,
Year Civil Service
Degree/Highest Name of Institution Rating Date
Received Examination
Grade Attained
BSIE SOUTHERN LEYTE STATE 2005 LET 76.80 August,2005
UNIVERSITY- SOGOD
SOUTHER LEYTE
CAR SURIGAO DEL SUR STATE 2019
UNIVERSITY- TANDAG
CITY

II. SERVICE RECORDS: (Attach duly certified Service Record)

III. – EQUIVALENT UNITS:
A. Total No. of Years Teaching : (Public Only) ____13 yrs. & 10 months Equivalent ________________
B. Degree to Degree Equivalent : (Present Degree) _____________________ Equivalent ________________
C. Areas of Equivalent : ____________________________________________________________

School Year No. of Units Description

1. Professional Study 2015-2019 30 MAEd
2. Teaching Experience
a. Public School 2012 - Present 7 years, 5 months
b. Private School 2006-2009 3 years
3. Adm./Supervisory Experience
a. Public School
b. Private School
4. Others (Seminars, Workshops,
Others)
TOTAL
4.211
LATEST EFFICIENCY RATING: ___________________________

CERTIFIED CORRECT: ______________________________

Teacher’s Signature

GEMMALYNDA P. MONTENEGRO, MAED SHIRLENE E. CRABAJALES

P-3, District In-Charge Administrative Officer V

Note: Teachers Do not Write Below

IV – DIVISION ACTION:
Range Scheduled of
CLASSIFICATION Date Processed Salary Range REMARKS
Assignment Salary

CERTIFIED CORRECT: APPROVED:

______________________________ MARILOU B. DEDUMO, CESO VI

Division Processing Officer Schools Division Superintendent
 OATH

I HEREBY CERTIFY under oath that I have actually enrolled in the school or
schools listed in accompanying transcript of record and that I have the units indicated therein.

As required the Bureau of Public Schools has been furnished with authentic copies of the
sworn statement and its enclosure.

________________________
Signature

SUBSCRIBE AND SWORN to before me this _______________ day of

_______________ 201_ affiant exhibiting his/her Residence Certificate No. ______________ Issued at
________________________ on ______________________________.

___________________________
Signature of Person Administering Oath

Doc. No._____________________
Page No. _____________________
Book No. _____________________
Series of _____________________