Republic of the Philippines

Department of the Interior and Local Government

BUREAU OF FIRE PROTECTION
Regional Office VI

Acct. Nr. :P14168

LEAVE RECORD
COMPLETE NAME : Pedrosa Jan Kit Salcedo RANK: FO2 DES: 1-December-14
(FAMILY NAME) (GIVEN NAME) (MIDDLE)

UNIT/ASSIGNMENT: ANINI-Y FIRE STATION DESIGNATION: CHIEF, IIU/Mun.SAO/Logistics/Driver Pump

Operator/FAI/Shift Supervisor

VACATION LEAVE SICK LEAVE

Particular Date & Action Taken on
PERIOD
s Earned LWP Balance LWOP Earned LWP Balance LWOP application for leave

1-Dec-14 − 31-Dec-14 0 1.250 0.000 1.250 1.250 0.000 1.250

1-Jan-15 − 31-Dec-15 5ML 15.000 5.000 11.250 15.000 0.000 16.250 Dec 7-11 2015
1-Jan-16 − 31-Dec-16 5ML 15.000 5.000 21.250 15.000 0.000 31.250 May 4,5 2016
1-Jan-17 − 31-Dec-17 5ML 15.000 5.000 31.250 15.000 0.000 46.250 Oct 21,22 & 23/ 2ML Deducted
1-Jan-18 − 31-Dec-18 5ML 15.000 5.000 41.250 15.000 0.000 61.250 5ML deducted
5ML Disapproved & *30MLC
1-Jan-19 − 31-Dec-19 *30MLC 15.000 30.000 26.250 15.000 0.000 76.250
Deducted
9MLC DEDUCTED/5ML
1-Jan-20 − 31-Dec-20 9MLC 15.000 9.000 32.250 15.000 0.000 91.250 Disapproved (March 27, 28, 29 &
May 3, 4, 2020)
5ML Disapproved (September 22,
1-Jan-21 − 31-Dec-21 15.000 0.000 41.250 15.000 0.000 91.250
23, 24, 25, 26)
5ML DISAPPROVED Apr. 5-9,
1-Jan-22 − 19-Dec-22 14.500 46.750 14.500 0.000 105.750
2022
1-Jan-23 − 19-Jan-23 0.792 0.000 47.542 0.792 0.000 106.542
1-Jan-23 − 31-May-23 6.250 0.000 53.792 6.250 0.000 112.792

127.792 59.000 68.792 127.792 0.000 127.792

RECAPITULATION
Balance as of 31-May-23
EARNED ENJOYED
Vacation Leave : 127.792 59.000 68.792
Sick Leave : 127.792 0.000 127.792
TOTAL : 255.583 59.000 196.583
TOTAL ACCRUED LEAVE : 196.5834

Per OP MO No. 54 CSC MC No. 10 Series of 1988 all accumulated leave earned as of June 16, 1960 is inclusive of Saturdays, Sundays &
Holidays while those leave earned beginning June 17, 1960 is exclusive of Saturday, Sunday & Holidays

I hereby certify on my official oath this document/computation is correct and I hold myself liable for any erroneous or unathorized payment due
to this document/certification.

Issued this 31st day of May 2023

PURPOSE: For Updating of 201 File

FO1 Ilonah Joy S Abreque SFO1 John Randolph B Baria

STATION LEVEL Station Admin Acting Municipal Fire Marshal

SFO1 Ryan Vic V Jabile SUPT PATRICIO G COLLADO, BFP

PROVINCIAL LEVEL Provincial Admin Acting Provincial Fire Marshal

SINSP MARICEL G CORDERO, BFP CSUPT JERRY D CANDIDO, DSC

BFP-QSF-PRMD-016 Rev. ØØ (5.07.18)

 REGIONAL LEVEL Regional Admin Regional Director

BFP-QSF-PRMD-016 Rev. ØØ (5.07.18)

 Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
PANDAN FIRE STATION- ANTIQUE
Brgy. San Andres Pandan, Antique
Hotline No. 278-9043/09064557022/09382708059
Email Address: [email protected]

STATEMENT OF SERVICE
(To be accomplished by Employer)

NAME: FO2 PEDROSA JAN KIT y SALCEDO (BFP)

(If married woman, give full maiden name)
BIRTH DATE : 26 March 1992 BIRTHPLACE: Pob. 5, Hamtic, Antique

(Data herein should be checked from birth or baptism certificate or some other reliable documents.)
COMPULSORY RETIRED: 26 March 2048

This is to certify that the above named employee have actually rendered services in this Office and other agency as shown by the service record below,
each line of which is supported by appointment and other papers actually issued by this Office and approved by the authorities concerned.

INCLUSIVE DATES RECORDS OF APPOINTMENT OFFICE/ENTITY

AUTHORITY
(FROM − TO) POSITION/ DESIGNATION STATUS SALARY STATION/PLACE

FO2/Mun. SAO/Logistic/Shift
22-Mar-23 - Present PERMANENT PHP 30,867.00 Anini-y Fire Station REA 2023-01-55
Supervisor/Chief, IIU/FAI

FO2/DPO/Shift Supervisor/Chief,
29-Dec-22 - 22-Mar-23 PERMANENT PHP 30,867.00 Pandan Fire Station RO#-DSG-2022-12-36
IIU/FAI

FO2/FTO/FAI/OLP Monitor/Team
29-Sep-22 − 28-Dec-22 Leader/Evidence Recovery & PERMANENT PHP 30,867.00 Banga Fire Station OO#:2022-09-001 dtd 29 Sep 22
Collector

FO2/FTO/C,IIS/OLP
6-May-22 − 28-Sep-22 Monitor/Team Leader/Evidence PERMANENT PHP 30,867.00 Banga Fire Station OO#:2022-05-002 dtd 06 May 22
Recovery & Collector

FO2/FTO/C,IIS/OLP
Monitor/FAI/Team
4-Apr-22 − 5-May-22 PERMANENT PHP 30,867.00 Banga Fire Station OO#:2022-04-002 dtd 04 Apr 22
Leader/Evidence Recovery &
Collector

FO2/FTO/FSI/C,IIS/OLP
Monitor/FAI/Team
16-Mar-22 − 3-Apr-22 PERMANENT PHP 30,867.00 Banga Fire Station OO#:2022-03-02 dtd 16 Mar 22
Leader/Evidence Recovery &
Collector/BPE
FO2/FTO/FSI/C,IIS/OLP
23-Dec-21 − 15-Mar-22 PERMANENT PHP 30,867.00 Banga Fire Station R6-PRM-2021-004 dtd 23 Dec 2021
Monitor/FAI/BPE
FO1/FTO/FSI/C,IIS/OLP
2-Dec-21 − 22-Dec-21 Monitor/FAI/Building Plan PERMANENT Php 29, 668.00 Banga Fire Station Office Order # DSG-2021-12-01
Evaluator

FO1/FTO/FSI/C,IIS/LM/NM/OLP
28-Jul-21 01-Dec-21 PERMANENT Php 29, 668.00 Banga Fire Station DSG-2021-07-01 dtd 28 July 2021
Monitor/FAI/BPE

FO1/FTO/FSI/IIS
8-Feb-21 28-Jul-21 PERMANENT Php 29, 668.00 Banga Fire Station DSG-2021-02-05 dtd 08 Feb 2021
Clerk/LM/NM/OLP Monitor/FAI
FO1/ FTO/ Fire Arson
25 Nov 20 − 07 Feb 21 PERMANENT Php 29, 668.00 San Jose Fire Station
Investigator
FO1 Nozzlemen/Linemen/ Fire
19 Nov 19 − 24 Nov 20 PERMANENT Php 29, 668.00 San Jose Fire Station
Arson Investigator
FO1 Nozzlemen/Linemen/ Fire
01 Jan 18 − 18 Nov 19 PERMANENT Php 29, 668.00 San Jose Fire Station
Arson Investigator/FSI
FO1 Nozzlemen/Linemen/ Fire
11 Mar 17 − 31 Dec 17 PERMANENT Php 14, 834 San Jose Fire Station
Arson Investigator/FSI
12 Oct 16 − 10 Mar 17 FO1 FRBC TEMPORARY Php 14, 834 NFTI,CVL, Laguna
FO1 Nozzlemen/Linemen/FAI/
08 Jun 16 11 Oct 16 TEMPORARY Php 14, 834 San Jose Fire Station
Fire Code Assessor
29 Dec 15 − 07 Jun 16 FO1 FAI/Lineman/Nozzleman TEMPORARY Php 14, 834 San Jose Fire Station
27 Apr 15 − 28 Dec 15 FO1 Nozzleman/Lineman TEMPORARY Php 14, 834 San Jose Fire Station
26 Mar 15 − 26 Apr 15 FO1 OJT TEMPORARY Php 14, 834 San Jose Fire Station
13 Feb 15 − 25 Mar 15 FO1 DUTY TEMPORARY Php 14, 834 ORDBFP R6
01 Dec 14 − 12 Feb 15 FO1 / ORIENTATION COURSE TEMPORARY Php 14, 834 ORDBFP R6
Page 1 of 1
xxx nothing follows xxx
PURPOSE: For Updating of 201 File.
DATE ISSUED: 22 May 2023

REMARKS:

Issued in compliance with Executive Order No. 54, dated August 10, 1954, and in accordance with Circular No. 58, dated August 10, 1954 of the system.

Prepared and Verified by: Certified Correct from Records:

FO1 Rudy G Gelogo FO1 Ilonah Joy S Abreque

Clerk, Admin Unit Chief, Admin Unit

BFP-QSF-PRMD-001Rev.ØØ(03.08.21)
 s

10

8
7

5
4
3
2
1

BFP-QSF-PRMD-001Rev.ØØ(03.08.21)
Civil Service Form No. 6

Revised 2020

Republic of the Philippines

Department of the Interior and Local Government Stamp of Date of Receipt

BUREAU OF FIRE PROTECTION

th
New BFP Building, Block 19-A 4 Main Avenue Phase 3, Alta Tierra
Village, Jaro, Iloilo City

APPLICATION FOR LEAVE

1. OFFICE/DEPARTMENT 2. NAME: (Last) (First) (Middle)
BANGA FIRE STATION Pedrosa Jan Kit Salcedo

3. DATE OF FILING March 31, 2022 4. POSITION

FO2-C,IIS/FTO/FSI/OLP Monitor/FAI/Team Leader/Evidence Recovery/Evidence 5. SALARY
P 30,867.00
Collector/Building Plan Evaluator

6. DETAILS OF APPLICATION

6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE

Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Vacation/Special Privilege Leave:

Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Within the Philippines

Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Abroad (Specify)

Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:
Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In Hospital (Specify Illness)
Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Out Patient (Specify Illness)
Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004) In case of Special Leave Benefits for Women:

Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) (Specify Illness)
10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) In case of Study Leave:

Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Completion of Master's Degree

Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) BAR/Board Examination Review Other

Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) purpose:

Adoption Leave (R.A. No. 8552) Monetization of Leave Credits

Others: Terminal Leave

6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION

5 days Not Requested

INCLUSIVE DATES Requested

April 5,6,7,8, and 9, 2022

(Signature of Applicant)

7. DETAILS OF ACTION ON APPLICATION

7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION

As of March 31, 2022

Vacation Leave Sick Leave For approval

Total Earned 110.000 110.000 For disapproval due to Full Alert Status of BFP
Less this application in connection with COVID-19 Pandemic.
Balance 51.000 110.000

FO1 Mary Joy B Palmes, BFP FO2 Phoebe O Tapar, BFP

Authorized Officer Authorized Officer

7.C APPROVED FOR: 7. D DISAPPROVED DUE TO: Full Alert Status of BFP

days with pay in connection with COVID-19 Pandemic.

days without pay

others (Specify)

SFO2 Felinor N Suco, BFP

Authorized Officer
Civil Service Form No. 6
Revised 2020

Republic of the Philippines

Department of the Interior and Local Government Stamp of Date of
Receipt
BUREAU OF FIRE PROTECTION
New BFP Building, Block 19-A 4th Main Avenue Phase 3, Alta Tierra
Village, Jaro, Iloilo City

APPLICATION FOR LEAVE

1. OFFICE/DEPARTMENT 2. NAME: (Last) (First) (Middle)
BANGA FIRE STATION PEDROSA JAN KIT SALCEDO

FO2-FTO/OLP Monitor/FAI/Team
3. DATE OF FILING October 31, 2022 4. POSITION
Leader/Evidence Recovery/ Evidence 5. SALARY PHP 30,867.00
Collector

6. DETAILS OF APPLICATION
6.A TYPE OF LEAVE TO BE AVAILED OF 6.B DETAILS OF LEAVE

Vacation Leave (Sec. 51, Rule XVI, Omnibus Rules Implementing E.O. No. 292) In case of Vacation/Special Privilege Leave:

Mandatory/Forced Leave(Sec. 25, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Within the Philippines

Sick Leave (Sec. 43, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Abroad (Specify)

Maternity Leave (R.A. No. 11210 / IRR issued by CSC, DOLE and SSS) In case of Sick Leave:
Paternity Leave (R.A. No. 8187 / CSC MC No. 71, s. 1998, as amended) In Hospital (Specify Illness)
Special Privilege Leave (Sec. 21, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Out Patient (Specify Illness)
Solo Parent Leave (RA No. 8972 / CSC MC No. 8, s. 2004) In case of Special Leave Benefits for Women:

Study Leave (Sec. 68, Rule XVI, Omnibus Rules Implementing E.O. No. 292) (Specify Illness)
10-Day VAWC Leave (RA No. 9262 / CSC MC No. 15, s. 2005) In case of Study Leave:

Rehabilitation Privilege (Sec. 55, Rule XVI, Omnibus Rules Implementing E.O. No. 292) Completion of Master's Degree

Special Leave Benefits for Women (RA No. 9710 / CSC MC No. 25, s. 2010) BAR/Board Examination Review Other

Special Emergency (Calamity) Leave (CSC MC No. 2, s. 2012, as amended) purpose:

Adoption Leave (R.A. No. 8552) / Monetization of Leave Credits

Others: Terminal Leave

6.C NUMBER OF WORKING DAYS APPLIED FOR 6.D COMMUTATION

30 days Not Requested

INCLUSIVE DATES / Requested

(Signature of Applicant)

7. DETAILS OF ACTION ON APPLICATION

7.A CERTIFICATION OF LEAVE CREDITS 7.B RECOMMENDATION

As of October 31, 2022

Vacation Leave Sick Leave / For approval

Total Earned 59.750 118.750 For disapproval due to
Less this application 30.000 -
Balance 29.750 118.750

CINSP ROWEL L LIMJUCO, BFP CSUPT JERRY D CANDIDO, DSC, BFP

Acting Provincial Fire Director Regional Director
Authorized Officer Authorized Officer

7.C APPROVED FOR: 7. D DISAPPROVED DUE TO:

days with pay
days without pay
30 MLC others (Specify)

FIRE DIRECTOR LOUIE S PURACAN, CEO VI

Chief, Bureau of Fire Protection
Authorized Officer