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Republika ng Pilipinas Kagawaran ng Edukasyon REHIYON XI Sangay ng Lungsod ng Dabaw PUROK NG STA.


The Schools Division Superintendent Davao City ( Through Channels ) Sir / Madam: This is to advice you that I have satisfactorily accounted for all money and property for which I was responsible in and the reports required of me have been submitted on the dates shown below: DepEd Form 1 DepEd Form 2 DepEd Form 18-E-1/18-E-2 DepEd Form 137-E DepEd Form 138-E DepEd 112 (Prop. Shortages) DepEd 113 C.S. Form 48 Property Inventory Elem. Certificate PTA Fund Pupil's Fund BSP Fund GSP Fund Anti-TB Jr. Red Cross Sr. Red Cross FHP PPSTA Eff. Date Membership DCPSTA Eff. Date Membership Shortages/Unpaid Balance to Date Resignation If so Division Form 25 attached Transfer to Leave Granted by S.O. no. Firearm deposited with P.C. at Receipt No. Date Complete files of official correspondents and Circulars literature for at least , year are kept in safely with the signature of the school custodian with other school properties. Are all test papers and test results filed with other records? My last day authorized services in this school was My mailing address is Total Number of days present during the school year ( maternity, sick, vacation ) Total days service rendered during the school year days VERIFIED: CRISTELYN M. FELIX Principal I Unang Paglipat Purok ng Sta. Ana Lungsod ng Dabaw Very truly yours,


Respectfully forwarded to the Schools Division Superintendent, Davao City, with the information that

the foregoing statements are correct and a complete clearance is hereby granted. EVA M. ANTIPUESTO District Supervisor

Class Record/Form 1 Phil IRI in folder (Fil and Eng) Lesson Plan Updated 201 File Annual P.E.

LEAH C. SAAVEDRA Guidance In - Charge

LEONORA CABAOG Teachers' Club Treasurer

Grade Head

ELADIO I. PUERTOS JR. Property Custodian

NANCY BEQUISO Teacher's Club President PAST Form In - Charge Grade Head



epublika ng Pilipinas gawaran ng Edukasyon REHIYON XI ay ng Lungsod ng Dabaw UROK NG STA. ANA Lungsod ng Dabaw