OFFICE OF THE VICE CHANCELLOR FOR FINANCE AND ADMINISTRATION
MEMORANDA 2011
University of the Philippines OPEN UNIVERSITY
University of the Philippines OPEN UNIVERSITY Office of the Vice Chancellor for Finance and Administration
Memoranda for the Year 2011 No.
Date
To
11- 001
01/05/2011 All Concerned
11- 002
01/05/2011 All Concerned
11- 003 11- 004
01/14/2011 All Admin Staff
11- 005
01/18/2011
11- 006
02/16/2011 All Concerned
11- 007
02/16/2011 All Concerned
11- 008
02/16/2011 All Concerned
11- 009
03/23/2011 All Concerned
11- 010
03/30/2011 All Concerned
11- 011
03/30/2011 All Concerned
11- 012
03/30/2011 All UPOU Employees
11- 013
04/19/2011
11- 014
04/26/2011 All Concerned
11- 015
04/29/2011 All Concerned
11- 016
05/11/2011
All UPOU Officials, Faculty & Staff
All UPOU Officials, Faculty & Staff
Subject Financial Assistance to the Family of Roselyn Gacosta Financial Assistance to the Family of Wyomia Pradas CANCELLED Submission of Performance Targets (PTs) for 2011 and Performating Ratings (PR )for 2010 Financial Assistance to the Family of Emily Amoloza Discount on All Diagnostic Services Offered at the UPM-PGH-Faculty Medical Arts Building (FMAB) CSC Memorandum Cicular No. 25 on the Guidelines on the Availment of the Special Leave Benefits for Women under RA 9710 CSC Memo Circulars on Undertime & Half-Day Absence Memo on Seminar on Fire Prevention CSC Memo Cicular No. 4 Series of 2011on the Policy and Guidelines on the Prohibition on the Consumption of Alcoholic Beverages Submission of Daily Time Record (DTR) & Certificate of Service (COS) 2010 Statement of Assets, Liabilities & Networth and Disclosure of Business Interest and Financial Connections Financial Assistance to the Family of Emely Amoloza University Policies for Authority to Fill Plantilla Items Adoption of Four-day Work Week in the University
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11- 017
All UPOU Official, Faculty & Staff 05/13/2011 All UPOU Employees
11- 018
05/31/2011 All UPOU Employees
11- 019
06/14/2011 All Concerned
11- 020
07/26/2011 Al UPOU Employees
Statement of Accumulated Value from Pag-ibig Fund/Hime Development Mutual Fund (HDMF)
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11- 021
07/26/2011 All UPOU Employees
Pag-big Fund II
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11- 022
08/02/2011 All UPOU Employees
Transfer to LBP as servicing bank of the GSIS
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Disaster Risk Reduction Seminar
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Pag-ibig Fund/HDMF Updates Financial Assistance to the Family of Joane Serrano Early submission of Peformance Ratings (PRs) for the Period January to June 2011
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No. 11- 023
Date
To All Administrative 08/31/2011 Officers/Assistants
11- 024 11- 025
05/27/2011 All LC Coordinators
11- 026
09/15/2011 All UPOU Employees All Administrative 09/22/2011 Officers/Assistants
11- 027
Subject Annual Medical Exam for 2011 CANCELLED Approved Student Loan for Fist Semester 20112012 HDMF Online Membership Registration Submission of Project Procurement Management Plan (PPMP) for 2012 Financial Assistance to the Family of Allan Pamulaklakin PhilHealth Insurance Updates Monetization of Leave Credits Approved Student Loan for Second Semester 2011-2012 Deadline for Submission of Requests for Fund Obligation, Payments of Expenditures for FY 2011 and Liquidation/Settelement of Cash Advances UPPFI – Cocolife Group Life Insurance Coverage Mandatory Christmas Break
11- 028
10/04/2011 Al UPOU Employees
11- 029 11- 030
10/07/2011 Al UPOU Employees 10/21/2011 All Concerned
11- 031
11/03/2011 All LC Coordinators
11- 032
11/04/2011 All Heads of Units
11- 033
12/06/2011 All Members of UPPFI
11- 034
12/13/2011 All Concerned UPOU Officials, Faculty 12/21/2011 Assistance for the Victims of Typhoon Sendong & Staff
11- 035
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SWORN STATEMENT OF ASSETS, LIABILITIES, AND NETWORTH DISCLOSURE OF BUSINESS INTERESTS AND FINANCIAL CONNECTIONS AND IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE As of __________________________ (Required by R.A. 6713) Name _________________________________________ (Surname) (First Name) (M.I.) Address: _______________________________________ _______________________________________________ Spouse Name ___________________________________ (Surname) (First Name) (M.I.)
Position/Income ______________________________ Office: UP Open University Office Address: UPOU Bldg., College, Los Banos, Laguna Position: ____________________________________ Office: ______________________________________
Unmarried children below 18 years of age NAME
Date of Birth
A. ASSETS, LIABILITIES AND NETWORTH 1. ASSETS a. Real Properties NATURE OF YEAR KIND
LOCATION
ACQUIRED
MODE OF
CURRENT
PROPERTY ASSESSED
ACQUISITION (Parapherral,
VALUE
conjugal or
ACQUISITION COST
FAIR
LAND
IMPROVE-
MARKET VALUE
BUILDING ETC.
MENTS
community)
TOTAL
P
b. Personal Properties KINDS
YEAR ACQUIRED
TOTAL 2. LIABILITIES (Loans, Mortgage, etc.) NATURE
ACQUISITION COST
P
NAME OF CREDITORS
NETWORTH (Total Assets (1a + 1b) less Total Liabilities (2)
AMOUNT
TOTAL
P
TOTAL
P
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Do you have any business interests and other financial connections including those of your spouse and unmarried children below 18 years of age living with you in your household? [ ] Yes [ ] No If yes, give particulars NAME
NAME OF FIRM/COMPANY
ADDRESS
NATURE OF BUSINESS
DATE OF
INTEREST AND/OR
ACQUISITION OR
FINANCIAL CONNECTION
CONNECTION
C. IDENTIFICATION OF RELATIVES IN THE GOVERNMENT SERVICE To the best of your knowledge, are you related within the fourth degree of consanguinity or of affinity to anyone working in the government [ X ] Yes [ ] No If yes, give particulars. NAME
POSITION
RELATIONSHIP
NAME/ADDRESS OF OFFICE
I hereby certify to the best of my knowledge and information, that these are true statements of my assets liabilities, networth, business interests and financial connections, including those of my spouse and unmarried children below 18 years of age and names of my relatives in the government as of _____________________ as required by and in accordance with Republic Act 6713. I hereby authorize the Ombudsman or his duly authorized representative to obtain and secure from all appropriate government agencies, including the Bureau of Internal Revenue, such documents that may show my assets, liabilities, networth, business interests and financial connections, to include those of my spouse and unmarried children below 18 years of age living with me in my household covering previous years to include the year I first assumed office in government. Date: ___________________, _______
_____________________________ Signature of Spouse TIN Com.Tax Cert No. Issued at Issued on
: ______________________ : ______________________ : ______________________ :______________________
________________________ Signature of Employee TIN : ______________________ Com.Tax Cert No. _________________ Issued at : ______________________ Issued on :_______________________
SUBSCRIBED AND SWORN to before me this _______ day of __________________, _______ affiant exhibiting his/her Community Tax Certificate as indicated above.
_________________________ (Person Administering Oath)
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FPF400
REQUEST FOR TRANSFER OF MEMBER'S RECORDS AND LOAN DETAILS (RTMRLD) _____________________ Date Dear Sir/Madam: I would like to request transfer of my membership records and loan details to the _________________ with the following information: Name of member: Last Name
First Name
θ Single θ Married θ Widow/er
Civil Status:
Name Extensions (Jr., Sr., II, etc.)
Middle Name (Maiden)
θ Legally Separated θ Annulled
Home Address: Telephone No.: Present Company/Employer:
UNIVERSITY OF THE PHILIPPINES OPEN UNIVERSITY (UPOU)
Company/Employer Address:
UPOU BLDG., COLLEGE, LOS BANOS, LAGUNA
Telephone No.:
049-536-6001 TO 06
Purpose of Transfer:
Check if with: θ Housing Loan Takeout date Loan Status Outstanding Balance
Company ID No.:
θ Claims θ STL θ Others, pls. Specify _____________
: : :
Name of Previous Company/Employer
θ Consolidation μ Intra-branch (within the branch) μ Inter-branch (among branches)
θ STL DV/Check Date Loan Status Outstanding Balance
: : :
Company/Employer Address/Contact No.
Inclusive Date(s)
1. 2. 3. 4.
Requesting Pag-IBIG Fund Branch: ______________________________
Requested by: Processed by: ___________________________________ Member's Signature Over Printed Name
Noted by: Revised 08/2008
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MODIFIED Pag-IBIG II REGISTRATION FORM (MP2RF) FOR HDMF USE ONLY
INSTRUCTIONS 1. Type or print all entries in BLOCK or CAPITAL LETTERS. 2. Submit this form and present at least one (1) valid ID. LAST NAME
FIRST NAME
NAME EXTENSION (e.g., Jr., III)
FPF096
MP2 ACCOUNT NO.
MIDDLE NAME
NO MIDDLE NAME
Pag-IBIG MID No./REGISTRATION TRACKING No.
(Check if applicable)
PRESENT HOME ADDRESS(Unit/Room No., Floor, Building Name or Lot No., Block No., Phase No. and Street Name)
(Subdivision, Barangay, Municipality/City, Province and State/Country, if abroad)
ZIP Code
DATE OF BIRTH (mm/dd/yyyy)
CONTACT DETAILS COUNTRY+ AREA CODE
TELEPHONE NUMBERS
Home EMPLOYER NAME Cell phone EMPLOYER ADDRESS (Unit/Room No., Floor, Building Name or Lot No., Block No., Phase No. and Street Name) Email Address (Subdivision, Barangay, Municipality/City, Province and State/Country, if abroad)
ZIP Code
GROSS MONTHLY INCOME
AUTHORITY TO DEDUCT (For locally-employed members) THIS IS TO AUTHORIZE MY PRESENT AND FUTURE EMPLOYER TO DEDUCT MY MP2 MONTHLY CONTRIBUTIONS IN THE AMOUNT OF ___________________________________ (P_____________) FROM MY SALARY AND REMIT THE SAME TO HDMF.
___________________________________________ SIGNATURE OF MEMBER OVER PRINTED NAME
TERMS AND CONDITIONS I HEREBY CERTIFY THAT I FULLY UNDERSTAND THE PROGRAM AND AGREE TO THE FOLLOWING TERMS AND CONDITIONS: 1. 2. 3. 4.
THE MP2 PROGRAM IS OPEN TO ALL Pag-IBIG I MEMBERS ONLY. THE REGISTRATION UNDER THIS PROGRAM SHALL BE SOLELY A SAVINGS SCHEME. THE MINIMUM CONTRIBUTION IS P500.00. THE ANNUAL DIVIDENDS SHALL BE CREDITED TO MY ACCOUNT IN ACCORDANCE WITH EXISTING HDMF POLICY. 5. THE MEMBERSHIP TERM SHALL BE FIVE (5) YEARS RECKONED FROM DATE OF INITIAL PAYMENT OF CONTRIBUTIONS UNDER THIS PROGRAM. 6. UPON MATURITY, I SHALL RECEIVE MY TOTAL SAVINGS WITH DIVIDENDS.
7. UPON MATURITY, I MAY OPT TO RENEW FOR ANOTHER FIVE (5) YEARS. IF I DID NOT WITHDRAW NOR RENEW UPON MATURITY, THE DIVIDEND RATE SHALL BE SUBJECT TO EXISTING HDMF POLICY. 8. IN CASE OF ANY CHANGE IN INFORMATION, I SHALL ACCOMPLISH THE MEMBER’S CHANGE OF INFORMATION FORM (MCIF) AND IMMEDIATELY NOTIFY HDMF. I FURTHER CERTIFY UNDER PAIN OF PERJURY THAT THE INFORMATION GIVEN AND ANY OR ALL STATEMENTS MADE HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF AND THAT MY SIGNATURE APPEARING HEREIN IS GENUINE AND AUTHENTIC. ___________________________________________ SIGNATURE OF MEMBER OVER PRINTED NAME
______________ DATE 7/2010
THIS FORM MAY BE REPRODUCED. NOT FOR SALE.
MODIFIED Pag-IBIG II REGISTRATION FORM (MP2RF) FOR HDMF USE ONLY
INSTRUCTIONS 1. Type or print all entries in BLOCK or CAPITAL LETTERS. 2. Submit this form and present at least one (1) valid ID. LAST NAME
FIRST NAME
NAME EXTENSION (e.g., Jr., III)
FPF096
MP2 ACCOUNT NO.
MIDDLE NAME
NO MIDDLE NAME
Pag-IBIG MID No./REGISTRATION TRACKING No.
(Check if applicable)
PRESENT HOME ADDRESS(Unit/Room No., Floor, Building Name or Lot No., Block No., Phase No. and Street Name)
(Subdivision, Barangay, Municipality/City, Province and State/Country, if abroad)
ZIP Code
DATE OF BIRTH (mm/dd/yyyy)
CONTACT DETAILS COUNTRY+ AREA CODE
TELEPHONE NUMBERS
Home EMPLOYER NAME Cell phone EMPLOYER ADDRESS (Unit/Room No., Floor, Building Name or Lot No., Block No., Phase No. and Street Name) Email Address (Subdivision, Barangay, Municipality/City, Province and State/Country, if abroad)
ZIP Code
GROSS MONTHLY INCOME
AUTHORITY TO DEDUCT (For locally-employed members) THIS IS TO AUTHORIZE MY PRESENT AND FUTURE EMPLOYER TO DEDUCT MY MP2 MONTHLY CONTRIBUTIONS IN THE AMOUNT OF ___________________________________ (P_____________) FROM MY SALARY AND REMIT THE SAME TO HDMF.
___________________________________________ SIGNATURE OF MEMBER OVER PRINTED NAME
TERMS AND CONDITIONS I HEREBY CERTIFY THAT I FULLY UNDERSTAND THE PROGRAM AND AGREE TO THE FOLLOWING TERMS AND CONDITIONS: 1. 2. 3. 4.
THE MP2 PROGRAM IS OPEN TO ALL Pag-IBIG I MEMBERS ONLY. THE REGISTRATION UNDER THIS PROGRAM SHALL BE SOLELY A SAVINGS SCHEME. THE MINIMUM CONTRIBUTION IS P500.00. THE ANNUAL DIVIDENDS SHALL BE CREDITED TO MY ACCOUNT IN ACCORDANCE WITH EXISTING HDMF POLICY. 5. THE MEMBERSHIP TERM SHALL BE FIVE (5) YEARS RECKONED FROM DATE OF INITIAL PAYMENT OF CONTRIBUTIONS UNDER THIS PROGRAM. 6. UPON MATURITY, I SHALL RECEIVE MY TOTAL SAVINGS WITH DIVIDENDS.
7. UPON MATURITY, I MAY OPT TO RENEW FOR ANOTHER FIVE (5) YEARS. IF I DID NOT WITHDRAW NOR RENEW UPON MATURITY, THE DIVIDEND RATE SHALL BE SUBJECT TO EXISTING HDMF POLICY. 8. IN CASE OF ANY CHANGE IN INFORMATION, I SHALL ACCOMPLISH THE MEMBER’S CHANGE OF INFORMATION FORM (MCIF) AND IMMEDIATELY NOTIFY HDMF. I FURTHER CERTIFY UNDER PAIN OF PERJURY THAT THE INFORMATION GIVEN AND ANY OR ALL STATEMENTS MADE HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF AND THAT MY SIGNATURE APPEARING HEREIN IS GENUINE AND AUTHENTIC. ___________________________________________ SIGNATURE OF MEMBER OVER PRINTED NAME
THIS FORM MAY BE REPRODUCED. NOT FOR SALE.
______________ DATE 7/2010
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