Date

CERTIFICATION
TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY UNDER OATH that I have beenactually enrolled in ______________________

School

__________________, _________________, _________________________________________.

Address Course

As listed in the enclosed Transcript of Records and that I have earned the units indicated thereon.
As required, the Department of Education has been furnished with authentic copies of the enclosure
in accrdance with the provisions of Department Order No. 12 s. 1962, and enclosure to Memo
no. 51 s. 1962.

(Signature over Printed Name of Teacher)

SUBSCRIBED AND SWORN TO before me this _______ day of _____________________, 20____

at __________________, affiant exhibiting her/his Residence Certificate No. ________________,
issued at ______________________ on ___________________.
 VOLUNTARY UNDERTAKING of APPLICANT

I, ______________________________, of legal age, and a resident of

___________________________________, applicant for reclassification of teacher position,
hereby VOLUNTARILY UNDERTAKE AND UNDERTSTAND, NOT to submit any application for
natural vacancies for teacher positions if my herein application is included in the approved
reclassification of teacher postitions from the Regional Office.
Further, it shall be my responsibility to verify from the proper office wether or not my
herein application is approved to ensure compliance with this voluntary undertaking.
This _____day of _________________20___ at Lagawe, Ifugao Philippines.

Name and Signature of Applicant

 Republic of the Philippines
DEPARTMENT OF EDUCATION
CORDILLERA ADMINISTRATIVE REGION

SCHOOLS DIVISION OFFICE - IFUGAO

Division

EQUIVALENTS RECORD FORM

Name: Date of Birth: __________ Gender: ___________
(Surname) (Given Name) (Middle Name)

Item Number: OSEC-DECSB-TCH__________ Position Title: _____________

School/District: ________________ Monthly Salary: ____________ CP #:_____________
I. EDUCATIONAL ATTAINMENT & CIVIL SERVICE ELIGIBILITY: _______________________________
Degree or Highest Level/ Year Graduated/ Eligibility
Name of Institution Rating Date
Units Earned Period of Attendance (CS Exam/PRC)

II. SERVICE RECORD: (attach duly certified Service Record)

A. Total number of years in teachi Public: Private: Equivalent:
B. Degree or Degree Equivalent: (present degree) Equivalent:
Period of Equivalent No. of Units Description
C. Areas of Equivalent Attendance/Service
1. Professional study
2. Teaching Experiences
a. Public School
b. Private School

III. SEMINARS, WORKSHOPS, ETC. (attached cps)

TOTAL:

IV. LATEST PERFORMANCE RATING:

Rating Period Rating (Numerical/Descriptive) Teacher's Signature

VERIFIED AND CERTIFIED CORRECT:

Name & Signature of School Head

cp#: ______________________
V. DIVISION ACTION:
Date
Classification Grade Assignment Salary Grade Monthly Salary Remarks
Processed

PROCESSED BY: CERTIFIED CORRECT: RECOMMENDING APPROVAL:

BEVERLY B. DAMUGGO JOHN N. GAHID GLORIA B. BUYA-AO

Administrative Officer V Schools Division Superintendent

VI. DepEd-CAR-RO Action:

DOCUMENTARY REQUIREMENTS FOR THE PROCESSING OF DOCUMENTARY REQUIREMENTS FOR THE PROCESSING OF
RECLASSIFICATION OF POSITION (ERF) RECLASSIFICATION OF POSITION (ERF)

Present Position: _________ Desired Position: __________ Present Position: _________ Desired Position: __________
Name: Name:
School/Dist. School/Dist.

1 EQUIVALENT RECORD FORM (ERF) - 4 COPIES 1 EQUIVALENT RECORD FORM (ERF) - 4 COPIES
ORIGINAL for the teacher ORIGINAL for the teacher
2ND COPY for the Regional Office Record Section 2ND COPY for the Regional Office Record Section
3RD COPY for the Division Office Record Section 3RD COPY for the Division Office Record Section
4TH COPY for the school 4TH COPY for the school

2 ORIGINAL TRANSCRIPT OF RECORDS (OTR) with 3 2 ORIGINAL TRANSCRIPT OF RECORDS (OTR) with 3
photocopies. photocopies.

3 SWORN STATEMENT of the teacher in compliance w/ the 3 SWORN STATEMENT of the teacher in compliance w/ the
provision of DO #12,s.1962, (Inclosure to MEMO. #52,s.1962) provision of DO #12,s.1962, (Inclosure to MEMO. #52,s.1962)
if the Teacher studied in a PRIVATE SCHOOL. (1 COPY) if the Teacher studied in a PRIVATE SCHOOL. (1 COPY)

4 ORIGINAL Copy of approved STUDY LEAVE/PERMIT/SCHOLARSHIP 4 ORIGINAL Copy of approved STUDY LEAVE/PERMIT/SCHOLARSHIP
AGREEMENT. (1 ORIGINAL COPY ) AGREEMENT. (1 ORIGINAL COPY )

5 Certification from the school on the area of SPECIALIZATION 5 Certification from the school on the area of SPECIALIZATION
in the given course STATING the number of units required to in the given course STATING the number of units required to
finish the course including the thesis writing and the number of finish the course including the thesis writing and the number of
LACKING UNITS (1 Original Copy) LACKING UNITS (1 Original Copy)

6 Complete SERVICE RECORD showing inclusive dates of paid 6 Complete SERVICE RECORD showing inclusive dates of paid
service/salary adjustments granted,duly certified by any service/salary adjustments granted,duly certified by any
authorized official. (1 COPY) authorized official. (1 COPY)

7 Latest PERFORMANCE RATINGS w/ at least Very Satisfactory 7 Latest PERFORMANCE RATINGS w/ at least Very Satisfactory
for the least 2 RATING PERIODS (1 COPY each) for the least 2 RATING PERIODS (1 COPY each)

8 Certificate of TRAININGS/SEMINARS of at least 3 DAYS 8 Certificate of TRAININGS/SEMINARS of at least 3 DAYS

(should be continuous) (1 ORIGINAL COPY) (Division level and higher) (should be continuous) (1 ORIGINAL COPY) (Division level and higher)

9 All documents in photocopies should be DULY CERTIFIED 9 All documents in photocopies should be DULY CERTIFIED
BY THE Admin officer or any authorized official/ BY THE Admin officer or any authorized official/
representative. representative.
REQ. FOR MASTER TEACHER POSITION REQ. FOR MASTER TEACHER POSITION
Name: _____________________
Present position: __________
Desired position: __________
Item No. _____________Mo. Salary: _______
School/Dist. __________ CP #: __________
Duly accomplished PSRC in 2 copies
DO
Updated Service Record
Ranklist of all teachers who are qualified applicants
or Waiver (if applicant isn't the most ranking)
Justification signed by the PSDS / School Head
Evaluation Sheet duly recommended by the SDO with categorical
statement or findings made by the reviewing committee as to the
applicants' qualification for the upgrading of his/her position and/or
compliance with the prescribed criteria or requirements. (credit pts on
leadership & potential should be indicated)
List of teachers: (w/ matrix showing deficiency in
the # of MT positions)
1. Elementary: No. of teachers per district
2. Secondary: No. of tachers per subject area
Original Transcript of Records
1 Certified photocopy of trainings/seminars certificates
photocopy of license
Qualification documents for MT criteria (per
inclosure to DO # 57, s. 1997)
MASTER TEACHER I
Permanent Teacher (latest appointment)
VS Performance Rating for the last 2 years
(at least 33 pts.) (IPCR for the last 2 S.Ys.)
At least 3 years of experience
At least with 25 pts. In the leadership and potential
or has been a demonstrattion teacher in the district
level with 15 pts. in leadership and potential.
MASTER TEACHER II
MT for atleast 1 year. (appointment)
VS performance rating for the last 2 years
( at least 33 pts. As MTI) (IPCR for last 2 Sys.)
Bachelor's Degree plus completion of academic
req'ts. For Master of Arts (Transcript of Record and
Certification)
At least with 30 pts. in leadership and potential or
has been a demonstration teacher in the division
level with 20 pts. in leadership and potential
provided the activities or accomplishments listed
for the purpose had not been credited or used for
earlier promotions.
Name: _____________________
Present position: __________
Desired position: __________
Item No.: _____________Mo. Salary: ________
School/Dist. __________ CP #: ____________
Duly accomplished PAL in 2 copies with CD
DO
Updated Service Record
Ranklist of all teachers who are qualified
applicants or Waiver (if applicant isn't the most
ranking)
Justification signed by the PSDS / School Head
Evaluation Sheet duly recommended by the SDO with categorical
statement or findings made by the reviewing committee as to the
applicants' qualification for the upgrading of his/her position and/or
compliance with the prescribed criteria or requirements. (credit pts
on leadership & potential should be indicated)
List of teachers: (w/ matrix showing deficiency in
the # of MT positions)
1. Elementary: No. of teachers per district
2. Secondary: No. of tachers per subject area
Original Transcript of Records
1 Certified photocopy of trainings/seminars certificates
photocopy of license
Qualification documents for MT criteria (per
inclosure to DO # 57, s. 1997)
MASTER TEACHER I
Permanent Teacher (latest appointment)
VS Performance Rating for the last 2 years
(at least 33 pts.) (IPCR for the last 2 S.Ys.)
At least 3 years of experience
At least with 25 pts. In the leadership and
potential or has been a demonstrattion teacher in
the district level with 15 pts. in leadership and
potential.
MASTER TEACHER II
MT for atleast 1 year. (appointment)
VS performance rating for the last 2 years
( at least 33 pts. As MTI) (IPCR for last 2 Sys.)
Bachelor's Degree plus completion of academic
req'ts. For Master of Arts (Transcript of Record and
Certification)
At least with 30 pts. in leadership and potential or
has been a demonstration teacher in the division
level with 20 pts. in leadership and potential
provided the activities or accomplishments listed
for the purpose had not been credited or used for
earlier promotions.
At least with 30 pts. in leadership and potential or
has been a demonstration teacher in the division
level with 20 pts. in leadership and potential
provided the activities or accomplishments listed
for the purpose had not been credited or used for
earlier promotions.
At least with 30 pts. in leadership and potential or
has been a demonstration teacher in the division
level with 20 pts. in leadership and potential
provided the activities or accomplishments listed
for the purpose had not been credited or used for
earlier promotions.
 DEPARTMENT OF EDUCATION - CORDILLERA ADMINISTRATIVE REGION
REQUIREMENTS FOR RECLASSIFICATION OF POSITIONS
(Per D.O. 97, s. 2011)

NAME OF APPLICANT: ________________________ School/District/Division: ___________________________

Current Position: __________________ For reclass to: _____________________
From SG ___Step ____ (Php____________) to SG 20 (Php _____________) Diff.: Php_______________
S NS
A. Applicants
1 Justification for the reclassification of position
2 Duly accomplished Form 212 (Personal Data Sheet)
3 Certified, Authenticated and Verified (CAV) Transcript of Records
4 Service Records
5 Performance Rating for the last tree (3) consecutive years

6 Certificates/proofs of Outstanding Accomplishments

7 ERF for HT positions; PDF for Principal Positions
NEAP Certification as to the result of the NQEP taken and Basic Training Course for School
8 heads attended; (QEP rating administered by the Region)

SBM Task Force's certification as to the rating obatined in the internal and external
9 stakeholders' assessment (signed by Applicant)

Division Selection and Promotions Board's Certification on the points obtained in the
10 Psychological Attributes and Personality Traits assessment, and ;

Enrolment Data (Form 3) in the present school assignment, including the cluster schools
11 handled, if any

B. Division Office
12 Copy of the latest PSIPOP where the item is reflected

13 List of teachers under supervision, with the identification of their respective plantilla item
number per latest PSIPOP
14 Copy of the latest PSIPOP wherein the names of teachers under supervision are reflected;
15 Certification of non-availability of item.

C. For Principal I Applicants:

16 Passed the NQEP and completed the Basic training course for School Heads as certified by
NEAP.

17 Obtained at least 50% of the indicators for internal and external stakeholders as assessed
and certified by the Division sbm Task Force using the SBM assessment tools;

18 Obtained at least 10 points of the Psychosocial Attributes and Personality Traits as

assesses by the Division Selection and Promotions Board

D. HT I-IV and PII-IV Applicants

19 Certification by the NEAP that they have attended the required trainings for the desired
position.

20 Trainings attended shall be attested as true and correct by the SDS and shall be submitted
to the NEAP thru the RO
Approved Evaluation Report with categorical statements or findings made by the
21 reviewing authorities/ committees as to the applicant's qualification for the upgrading of
her/his position and / or compliance with the prescribed criteria or requirements.
Applicant must submit either a proof of impact of the training on school performance and
22 improvement in the school operations or any aspect that the training hopes to address or
Re-Entry Action Plan (REAP) supervised by the HRD's.
Reminders:
 Training must be: a. conducted within five years after submission
b. at least three (3) days
c. not used for previous promotion
*** ALL REQUIREMENTS TO BE SUBMITTED IN THREE (3) COPIES EACH; ALL PHOTOCOPIES OF CERTIFICATES OF TRAININGS ATTENDED/
RECOGNITION SHOULD BE CERTIFIED BY THE SCHOOLS DIVISION SUPERINTENDENT ONLY.
Legend: S= Submitted NS= Not Submitted

FOR PROCESSING PENDING (Add'l req'ts/docs needed)

Evaluated by: Approved: Noted by:

HARIET P. BACDANGAN GERALDINE B. GAWI GLORIA B. BUYA-AO

HRMO OIC-ASDS / PSB Chairman Schools Division Superintendent
____________
_____

REMARKS
OF TRAININGS ATTENDED/

GLORIA B. BUYA-AO
ols Division Superintendent
 DEPARTMENT OF EDUCATION - CORDILLERA ADMINISTRATIVE REGION
REQUIREMENTS FOR RECLASSIFICATION OF POSITIONS
(Per D.O. 97, s. 2011)

NAME OF APPLICANT: ______________________ School/District/Division:____________________________

Current Position: ________________ For reclass to: ____________________
From SG ___ Step ___ (Php _________) to SG ___ (Php ___________) Diff.: Php _____________
S NS
A. Applicants
1 Justification for the reclassification of position
2 Duly accomplished Form 212 (Personal Data Sheet)
3 Certified, Authenticated and Verified (CAV) Transcript of Records
4 Service Records
5 Performance Rating for the last tree (3) consecutive years

6 Certificates/proofs of Outstanding Accomplishments

7 ERF for HT positions; PDF for Principal Positions
NEAP Certification as to the result of the NQEP taken and Basic Training Course for School
8 heads attended; (QEP rating administered by the Region)

SBM Task Force's certification as to the rating obatined in the internal and external
9 stakeholders' assessment (signed by Applicant)

Division Selection and Promotions Board's Certification on the points obtained in the
10 Psychological Attributes and Personality Traits assessment, and ;

Enrolment Data (Form 3) in the present school assignment, including the cluster schools
11 handled, if any

B. Division Office
12 Copy of the latest PSIPOP where the item is reflected

13 List of teachers under supervision, with the identification of their respective plantilla item
number per latest PSIPOP
14 Copy of the latest PSIPOP wherein the names of teachers under supervision are reflected;
15 Certification of non-availability of item.

C. For Principal I Applicants:

16 Passed the NQEP and completed the Basic training course for School Heads as certified by
NEAP.

17 Obtained at least 50% of the indicators for internal and external stakeholders as assessed
and certified by the Division sbm Task Force using the SBM assessment tools;

18 Obtained at least 10 points of the Psychosocial Attributes and Personality Traits as

assesses by the Division Selection and Promotions Board

D. HT I-IV and PII-IV Applicants

19 Certification by the NEAP that they have attended the required trainings for the desired
position.

20 Trainings attended shall be attested as true and correct by the SDS and shall be submitted
to the NEAP thru the RO
Approved Evaluation Report with categorical statements or findings made by the
21 reviewing authorities/ committees as to the applicant's qualification for the upgrading of
her/his position and / or compliance with the prescribed criteria or requirements.
Applicant must submit either a proof of impact of the training on school performance and
22 improvement in the school operations or any aspect that the training hopes to address or
Re-Entry Action Plan (REAP) supervised by the HRD's.
Reminders:
 Training must be: a. conducted within five years after submission
b. at least three (3) days
c. not used for previous promotion
*** ALL REQUIREMENTS TO BE SUBMITTED IN THREE (3) COPIES EACH; ALL PHOTOCOPIES OF CERTIFICATES OF TRAININGS ATTENDED/
RECOGNITION SHOULD BE CERTIFIED BY THE SCHOOLS DIVISION SUPERINTENDENT ONLY.
Legend: S= Submitted NS= Not Submitted

FOR PROCESSING PENDING (Add'l req'ts/docs needed)

Evaluated by: Approved: Noted by:

HARIET P. BACDANGAN GERALDINE B. GAWI GLORIA B. BUYA-AO

HRMO OIC-ASDS / PSB Chairman Schools Division Superintendent
_________
__

REMARKS
F TRAININGS ATTENDED/

GLORIA B. BUYA-AO
ols Division Superintendent