Basic Paper for SA
OSSS Form No. 3
University of the Philippines
Diliman, Quezon City
BASIC PAPER FOR GRADUATES/ STUDENT ASSISTANT
[ ] Original [ ] Reappointment [ ] Renewal [ ] Item/ Unit Transfer [ ] Change of designation
1. Name (Surname, First Name, M.I.) : Bithdate : Citizenship : 2. College/ Unit/ Office/Div./Dept.
: : :
: : :
Employee No. : TIN: :
3. Degree Institution Year ( For STFAP SA only: State Bracket Assignment)
4. Previous / present designation : Unit Code : PSI No. : Rate/hour not to exceed 100 hours
- : : a month ot the limits to be imposed
- : : by the chairman
_________________________________________________________________________________ 5, Proposed Designation : Unit Code : PSI No. : Rate/hour not to exceed 100 hours
- : : a month ot the limits to be imposed
- : : by the chairman
_________________________________________________________________________________
6. To replace 7. Conditions of apponiment 8. Effectivity date: From: To: 9. Justification (For SA only – Specify function/duties)
10. Recommended by: : 11. Endorsed by: : : Chairman/Head : Dean/Director/Head Date Div./Dept/Office : College/Unit/Office 12. OSSS Clearance: : 13. Budget Clearance: : Code/IOB No. : PSI No. : Designation : Rate: Chief Date : Effectivity Date : : Budget Director Date 14. Approval
Vice-Chancellor for Student Affairs Date