Department of Education

Region III
Division of Pampanga
MASANTOL HIGH SCHOOL
Masantol, Masantol
TEACHERS CLEARANCE
(Enter Date of Report or Not Required on the space provided below)
The Regional Director
Region III
City of San Fernando (P)
Thru the School Division Superintendent
Madam:
I have the honor to advise you that I have satisfactorily accounted for all money and property for which I
was responsible in this school and that all reports required of me were submitted on the date shown below:
1. Form I _________________________________
2. Form II ________________________________
3. Form 137-A ____________________________
4. Form 138-A ____________________________
5. Form 20 _______________________________
6. C.R.T. _________________________________
7. Form 18-A _____________________________
8. Lesson Plan ____________________________
9. IPPD _________________________________
10. Performance Contract ___________________

11. Textbooks ____________________________________

12. Grading Sheets ________________________________
13. Consolidated Grading Sheet _____________________
14. Instructional Materials __________________________
15. Test Results (Periodic Tests) _____________________
16. Test Results (Pre Test, RAT) _____________________
17. T.O.S _______________________________________
18. School Money Responsibility ____________________
19. School Property Responsibility ___________________
20. Accomplishment Report ________________________

URDANITA A. MAGAT
Principal-II
ABSENCES FOR THE LAST THREE MONTHS (January, February, and March)
Inclusive Dates

Until further notice my mailing address will be

Cause

__________________________________________
__________________________________________
__________________________________________

REMARKS

Very truly yours,

__________________________________________
Signature Over Printed Name
APPROVED:
NICOLAS T. CAPULONG, Ph. D.,CESO VI
Schools Division Superintendent - OIC