Republic of the Philippines

DEPARTMENT OF EDUCATION
MUNICIPALITY OF PAYAO
Region IX, Zamboanga Peninsula
Barangay BULAWAN

OFFICE OF THE PUNONG BARANGAY

CERTIFICATION
To whom it may concern:
THIS IS to CERTIFY that the barrowers of the book were student who dropped
and cant anymore be identified their whereabouts; others also were the one who
transferred in residence.
THIS IS TO CERTIFY FURTHER that as per record, the following are the books
observed as being lost, to wit:

Name of Books

Numbers of Pieces

1. SCIENCE I: INTEGRATED SCIENCE I

2. SCIENCE ll: BIOLOGY
3.SCIENCE III: CHEMISTRY
4. SCIENCE IV: PHYSICS
5. MATH I: ELEMENTARY ALGEBRA
(NPSBE)
6. MATH ll: INTERMEDIATE ALGEBRA
(NPSBE)
7. MATH lll: GEOMETRY (NPSBE)
8. MATH IV: ADVANCE ALGEBRA (NPSBE)
9. ENG. I: VENTURE IN COMM. I
10. ENG. II: ENGLISH EXPRESSWAYS ll
11. ENG. IV: ENGLISH EXPRESSWAYS
12. AP l: ISANG SULYAP AT PAGYAKAP l
13. AP ll: ASYA SA PAG-USBONG NG
KABIHASNAN
13. T.L.E. ll: TECH. and LIVELIHOOD
EDUC. Il
14.MUSIC AND ARTS I
15. MUSIC AND ARTS lll
16.FILIPINO III: GINTONG PAMANA
17. FILIPINO IV: GINTONG PAMANA
18. MATH I: ELEMENTARY ALGEBRA
(SEDIP)
19. MATH II: INTERMEDIATE ALGEBRA
(SEDIP)
20. MATH IV: ADVANCED ALGEBRA
(SEDIP)

7
11
6
3
5
24
11
2
12
9
6
21
24
8
11
8
1
2
13
13
3

NOTHING FOLLOWS
THIS CERTIFICATION is being issued upon the request of Mr. Oliver J. Empinado
Secondary School Teacher of BULAWAN NATIONAL HIGH SCHOOL for whatever
legal purposes it may serve him best.

ISSUED this __________ day of ______________ at the office of the Punong Barangay of
__________________, ___________________ , Zamboanga Sibugay Philippines.

HON.
ANTONIO CABRERA
Punong
Barangay
REPUBLIC OF THE PHILIPPINES
IPIL, ZAMBOANGA SIBUGAY
X
JOINT AFFIDAVIT OF TWO DISINTERESTED PERSON
We, ___________________________ and _____________________________ , both of legal age ,
married and resident of Bulawan, Payao, Zamboanga Sibugay , under oath hereby depose
and say:
1. That we are both barangay officials of Bulawan, Payao, Zamboanga Sibugay.
2. That the students who borrowed the books were known as the one who dropped and cant
be identified their whereabouts anymore; thus also were transferred out due to transfer of
residence;
3. As per record the following number of books was not retrieved.

Name of books

Number of pieces

1. SCIENCE I: INTEGRATED SCIENCE I

2. SCIENCE ll: BIOLOGY
3.SCIENCE III: CHEMISTRY
4. SCIENCE IV: PHYSICS
5. MATH I: ELEMENTARY ALGEBRA
(NPSBE)
6. MATH ll: INTERMEDIATE ALGEBRA
(NPSBE)
7. MATH lll: GEOMETRY (NPSBE)
8. MATH IV: ADVANCE ALGEBRA (NPSBE)
9. ENG. I: VENTURE IN COMM. I
10. ENG. II: ENGLISH EXPRESSWAYS ll
11. ENG. IV: ENGLISH EXPRESSWAYS
12. AP l: ISANG SULYAP AT PAGYAKAP l
13. AP ll: ASYA SA PAG-USBONG NG
KABIHASNAN
13. T.L.E. ll: TECH. and LIVELIHOOD
EDUC. Il
14.MUSIC AND ARTS I
15. MUSIC AND ARTS lll
16.FILIPINO III: GINTONG PAMANA
17. FILIPINO IV: GINTONG PAMANA
18. MATH I: ELEMENTARY ALGEBRA
(SEDIP)
19. MATH II: INTERMEDIATE ALGEBRA

7
11
6
3
5
24
11
2
12
9
6
21
24
8
11
8
1
2
13
13
3

(SEDIP)
20. MATH IV: ADVANCED ALGEBRA
(SEDIP)

4. That the diligent the effort exerted to locate said items, but to no avail and considered
beyond recovery.
5. That we are executing this affidavit to arrest to have veracity of the above statement;
I WITNESS WHEREOF , we hereunto set our hands this __________ day of ____________ Ipil,
Zamboanga Sibugay.

___________________ __________
Affiant
Affiant
CTC No: _____________
No.______________________
ON: _________________
________________________
AT: _________________
AT_________________________

____________________________

CTC
ON:

SUBSCRIBED AND SWORN to before me this ___________ day of __________ at ____________

______ Zamboanga Sibugay.

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula

DIVISION OF ZAMBOANGA SIBUGAY

BULAWAN NATIONAL HIGH SCHOOL
Bulawan, Payao, Zamboanga Sibugay

WASTE MATERIALS REPORT

As of _______________
Item
No.

Qty.

Unit

Description

Record of
Sales
Unit
amou
price
nt

Classification

Prepared by:

Approved by:

OLIVER J. EMPINADO
D. ARQUILITA, MMEM
School Designate Property Custodian/
Supply Officer

SALVADOR
School Head

CERTIFICATION OF INSPECTION
I hereby certify that this property enumerated above was disposed as follows:
Item ________ Condemned by burning
Item _________Destroyed
Item_________ Sold at Private Sale
Item_________Sold at Public Auction
Item_________ Transferred without cost to_________
Property Inspector:

_________________________
Designate Property Inspector

Witness of Disposition:

____________________________
COA Auditor