ࡱ> GF \p Shiela_PC Ba==h[, 8X@"1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1)Arial1 )Arial1$)Arial1)Arial1)Arial1)Arial1)Arial1)Arial"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)                + ) , *     (@  (  @    8@  8   8@  (   8   8  8   (   ( @   (  (  #8   ( #8 "8   8@ 0 8 8 8 !8 "8@ "8 !8@  !8 "8  8  ( !8 !8@  (  (  (@@  (@  (@  #8 !8  @ #8 !8  8   "8  "8  @ #8@ "8  @  (  ( 8 8   x@   x  (@ 8@ 8 8 "8 !8 !8 !8@   8@   8  8  8@  8  8   8   8  "8  "8  !8@  !8   8@   8 "8 "8   8@   8  8 !8 @ !8   8 8@ 8 8  8@ !8 "8@ !8 8@ *8@ 8@@ 8 @  8@  8 *8 !8 !8 "8 "8 @ "8  8  8  *8 8  @ 8  8@@   8@  "8  "8   8@@  !8 !0 8 8 8 @ 8 8   #  ` &ERRF j[GUIDE"ZR<3 A@@  }xRepublic of the PhilippinesREQUEST FOR EXAMINATION RECORDSCertification of EligibilityAuthentication of EligibilityVerification of EligibilityOthers: First Name Middle NameDate of Birth:Place of Birth:Purpose of Request:Rating Obtained:0Reg. No. for PD 1006/RA 1080/Other Special Laws:Presently employed? (Yes or No)Registration Date:B(Failure to fill up this portion shall mean denial of the request) ACTION TAKEN Picture/Photo Signature Date of BirthRELEASE OF REQUEST/S Received byFeeO.R. No.REMARKS=Book No. Page No. Seq./Line No.5School Code/Batch No. Examinee/Reg. No. Contact No.Title of Exam/Eligibility:Place of Exam/Issuance:3Name/Signature/Initial of Verifiers and Validators:!Attested by: ___________________ Not In Order6Authorized Representative (Printed Name and Signature) Requested By: Date: 1st Verifier:Date:2nd Verifier: 91st Validator: 2nd Validator:In Order Date: NO AVAILABLE RECORDName of Examinee/Eligible: Last NameCurrent/Mailing Address:%If yes, specify Employer and Address:' CIVIL SERVICE COMMISSION SECURITY FORM NO. (for lost original certificate) (attach original certificate)Date of Exam/Issuance:5(Please see Guide and Requirements at the back page.) Date:!Address Used at the Time of Exam:2Name Used at the Time of Exam (for Married Women):Gender: Civil Status:Time: (July 2009), OFFICE NAME'Examination Records Request Form (ERRF) Released by,EXAMINATION/ELIGIBILITY DATA (Please print.) $PERSONAL INFORMATION (Please print.)  # #Printed Name & Signature of Cllient Time:_______ Date:_______ Action Officer(Examinee/Eligible) Contact No.5 Right Thumb Print- CHECKED DATA AGAINST THE ML. CHECKED DATA AGAINST THE PSP Signature of the  Examinee/Eligible* Signature at the Time of Exam Date Released:BGUIDE IN ACCOMPLISHING THE EXAMINATION RECORDS REQUEST FORM (ERRF)M 1. Do not leave any blank unanswered in accomplishing the request form.p 2. Make sure that all information you provide are true and as written in your application for examination.9 3. Right thumb print are clear and without smudges.CHECKLIST OF REQUIREMENTS@A. CERTIFICATION OF ELIGIBILITY (for lost original certificate)v 1. One piece "1 inch by 1 inch" picture with name tag and signature affixed prior to having the photograph taken; * Signature must be on top of the printed name.T * The photograph should have been taken within three (3) months prior toB filing of request for Certification of Eligibility.T * Scanned, computer-generated photo/name/signature will not be accepted.# 2. Properly accomplished ERRF+ 3. Two (2) valid Identification Cards/ 4. Certification fee: Php100.00 per copyy 5. If through a representative or if the requesting party is abroad, please refer to additional requirements below.!B. AUTHENTICATION OF ELIGIBILITY@ 1. Original Certificate of Eligibility or Report of RatingY 3. One (1) valid Identification Card (if requesting party is the examinee/eligible)t Two (2) valid Identification Cards of the examinee/eligible (if request is filed through a representative)/ 4. Authentication fee: Php50.00 per copy"Choices for Identification Card/s: 1. Company ID4. Voter's ID7. Driver's License10. NBI Clearance 2. Taxpayer's ID 5. SSS ID8. PRC License11. Police Clearance 3. Passport 6. GSIS ID9. NBT LicenseADDITIONAL REQUIREMENTSUA. If request for certification or authentication is filed through a Representative:F 1. Authorization Letter or Special Power of Attorney (SPA); andA 2. One (1) valid Identification Card of the representative.VB. If the requesting party of the certification or authentication Works/Lives Abroad: 1. Copy of Passport; and}@ duly authenticated/validated by the Philippine Embassy or- 2. Copy of one (1) Identification Card. 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