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    AAO Form 09 14 2009-Revised 0625-2015franklin

    Uploaded by

    Zandie Garcia
    1) Franklin M. Viernes of Dipaculao Water District is applying to be the new Agency Authorized Officer for the district. 2) The application provides his contact details and mother's maiden name for verification purposes. 3) It includes signatures from Viernes as the requesting AAO and Romulo M. Dispo Jr. as the indorsing general manager of the water district approving the application.

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    AAO Form 09 14 2009-Revised 0625-2015franklin

    Uploaded by

    Zandie Garcia
    1K views1 page
    1) Franklin M. Viernes of Dipaculao Water District is applying to be the new Agency Authorized Officer for the district. 2) The application provides his contact details and mother's maiden name for verification purposes. 3) It includes signatures from Viernes as the requesting AAO and Romulo M. Dispo Jr. as the indorsing general manager of the water district approving the application.

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    1) Franklin M. Viernes of Dipaculao Water District is applying to be the new Agency Authorized Officer for the district. 2) The application provides his contact details and mother's maiden name for verification purposes. 3) It includes signatures from Viernes as the requesting AAO and Romulo M. Dispo Jr. as the indorsing general manager of the water district approving the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1K views1 page

    AAO Form 09 14 2009-Revised 0625-2015franklin

    Uploaded by

    Zandie Garcia
    1) Franklin M. Viernes of Dipaculao Water District is applying to be the new Agency Authorized Officer for the district. 2) The application provides his contact details and mother's maiden name for verification purposes. 3) It includes signatures from Viernes as the requesting AAO and Romulo M. Dispo Jr. as the indorsing general manager of the water district approving the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    PASEGURUHAN NG MGA NAGLILINGKOD SA PAMAHALAAN

    (GOVERNMENT SERVICE INSURANCE SYSTEM)


    Financial Center, Pasay City, Metro Manila 1308

    AAO ELECTRONIC ONLINE SYSTEM FORM

    Agency Authorized Officer Data Sheet New Renewal Termination Reactivation

    Agency Name DIPACULAO WATER DISTRICT

    Agency BP No

    Agency Address North Poblacion, Dipaculao, Aurora

    GSIS Old ID No./BP No. 2001990419


    Last Name VIERNES
    First Name FRANKLIN
    Middle Name MACTAL
    Salary Grade 4
    Employment status PERMANENT
    Agency Authorized Officer Contact Details
    Mobile Number: 0918 712 2712
    Office Number with Area Code
    Email Address [email protected]
    Agency Authorized Officer Mothers Maiden Name Information
    Mothers Maiden Last Name MACTAL
    Mothers First Name TRINIDAD
    Mothers Maiden Middle Name MAPANAO
    Signatures of Requesting Agency Officers
    Agency Authorized Officer: Type:

    __FRANKLIN M. VIERNES__ Water Resources Facilities Operator-C_ __8/9/2017________ ( ) Principal


    Signature over Printed Name Designation/Position Date Accomplished
    ( ) Alternate

    Indorsing Officer:

    __ROMULO M. DISPO JR.___ ___General Manager____


    Signature over Printed Name Designation/Position ________________
    Date Accomplished
    Mobile No. __0929 549 0454____ Email [email protected]_

    We understand that by affixing our signatures on the above, authorization when granted, is specific
    to the office specified in this application form. Moreover, it will be disabled after GSIS receives a
    request for termination.
    Please Do Not Fill-Up. For GSIS Use Only
    Reviewed by GSIS Accounts Management Staff

    Approved by GSIS Department Manager Date Accomplished

    Action Taken Initial & Date

    Authorization Enabled Authorization Disabled

    Notes:
    1. All boxes MUST be filled up (Type or Print) except signature/designation portion of AAOs for
    TERMINATION.
    2. Authorizations are valid until request for termination is received by the GSIS.

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