Republic of the Philippines

Department of Education
Region IV-A CALABARZON
Division of Tanauan City
District of Tanauan City North
PANTAY ELEMENTARY SCHOOL
Individual Pass/Time Adjustment Slip
To be filled up by the requesting Employee

(Printed name of employee and signature) Date

Permission is requested to:

Leave the school premises

During office hours from:
Intended time of Departure
To intended time of Arrival

Deviate from my fixed time of arrival

From to:
(Fixed Time)

Purpose: Official Personal

Reason:

To be filled up by the approving authority

Approved By:

EDWIN M. CASTILLO
Teacher-In-Charge
Actual time of Departure
Actual time of Arrival

EDWIN M. CASTILLO
Teacher-In-Charge

Republic of the Philippines

Department of Education
Region IV-A CALABARZON
Division of Tanauan City
District of Tanauan City North
PANTAY ELEMENTARY SCHOOL
Individual Pass/Time Adjustment Slip
To be filled up by the requesting Employee

(Printed name of employee and signature) Date

Permission is requested to:

Leave the school premises

During office hours from:
Intended time of Departure
To intended time of Arrival

Deviate from my fixed time of arrival

From to:
(Fixed Time)

Purpose: Official Personal

Reason:
 To be filled up by the approving authority
Approved By:

EDWIN M. CASTILLO
Teacher-In-Charge

Actual time of Departure

Actual time of Arrival

EDWIN M. CASTILLO
Teacher-In-Charge
Republic of the Philippines
Department of Education
egion IV-A CALABARZON
Division of Tanauan City
strict of Tanauan City North
TAY ELEMENTARY SCHOOL
al Pass/Time Adjustment Slip
lled up by the requesting Employee

Date

filled up by the approving authority

EDWIN M. CASTILLO
Teacher-In-Charge

EDWIN M. CASTILLO
Teacher-In-Charge

Republic of the Philippines

Department of Education
egion IV-A CALABARZON
Division of Tanauan City
strict of Tanauan City North
TAY ELEMENTARY SCHOOL
al Pass/Time Adjustment Slip
lled up by the requesting Employee

Date
filled up by the approving authority

EDWIN M. CASTILLO
Teacher-In-Charge

EDWIN M. CASTILLO
Teacher-In-Charge