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BPSU-AS Form (Employee's Clearance)

BATAAN PENINSULA STATE UNIVERSITY


City of Balanga 2100 Bataan
PHILIPPINES

EMPLOYEE'S CLEARANCE
Date
GREGORIO J. RODIS, Ph.D.
University President
Sir:
I have the honor to advise you that I have satisfactorily accounted for all money and property for which I am responsible in this
institution and that all reports required of me were submitted on the dates shown below.

REPORTS REQUIRED FOR SUBMISSION


\

(Enter date of report or write "not required" on space provided with the signature/initial of the authorized personnel)

Individual Faculty Report

Liquidation of Cash Advance

Accomplishment Report

Statement of Assets,

(for Advisers/Moderators

Liabilities and Net Worth

of Student Organizations)

ABSENCE DURING THE LAST THREE (3) MONTHS


(to be accomplished by the Office of the Administrative Services)
Inclusive Dates

Cause

My complete mailing adress will be:


Date of Original
Appointment

Last Day in Government


Service

Reason of Separation
from Service
(Signature over printed name)

PURPOSE OF CLEARANCE

Summer Vacation

Transfer of Campus

Travel Abroad

Separation From Service

AS TO MONEY AND PROPERTY RESPONSIBILITY


(Campus Level)

Immediate Head/Superior

Registrar

Librarian

Supply Officer / Incharge

Accountant / Incharge, Accounting

OAS Officer / Incharge

President, FAsso / Vice President, FAsso Teaching / Non-Teaching

1st Indorsement
(Date of Indorsement)

Respectfully forwarded to the concerned Vice President, endorsing the clearance of the above-named employee. Clearance
was sought from the concerned offices and all required reports were submitted. Likewise, This also reflects the last day of actual
service of the said employee.
The foregoing statements are correct, hence, a complete clearance is hereby endorsed.

Campus Director

2nd Indorsement
(Date of Indorsement)

Respectfully forwarded to the President of Bataan Peninsula State University, recommending clearance of the above-named
employee as duly endorsed by the Campus Director.
The foregoing statements are correct, hence, a complete clearance is hereby recommended.

EMMANUEL C. MACARAEG, Ph.D., CESE

EDMUNDO C. TUGOL, Ed.D.

RUDY C. FLORES, MSA

VP Academic Affairs

VP Administration & Finance

VP Research, Extension & Auxiliary Services

(Please refer at the back of this form for further instructions.)

INSTRUCTION
1

FORMS REQUIRED FOR SUBMISSION


(a)

All faculty members are required to submit the following reports/dcouments to appropriate offices.
a.1

Individual Faculty Report

Office of the College Dean

Liquidation of Cash Advance


a.2

a.3
a.4
2

(for those included in the list proivded by the Accounting Office with
existing or ageing cash advances)

Accomplishment Report

Office of the University Accountant

Office of the Student Affairs

(for Advisers/Moderators of Student Organizations)

Statement of Assets, Liabilities and Net Worth

Office of Administrative Services

ABSENCES DURING THE LAST THREE (3) MONTHS


This part shall be accomplished by the Office of the Administrative Services.

SIGNATORIES AS REGARD TO MONEY AND PROPERTY RESPONSIBILITY


(a)

(b)

For Faculty Members


Registrar

Accountant / Incharge, Accounting Office

Librarian

Immediate Head/Superior

Supply Officer / Incharge

President/Vice President, Fasso Teaching

OAS Officer / Incharge

Vice President, FAsso Non-Teaching

For Support Personnel / Non-Teaching Employees


Supply Officer / Incharge

Immediate Head/Superior

OAS Officer / Incharge

President/Vice President, Fasso Teaching

Accountant / Incharge, Accounting Office

Vice President, FAsso Non-Teaching

CLEARANCE FLOW
(a)

(b)

For Faculty Members


Dean

Librarian

Registrar

Supply Officer / Incharge

Campus Director

Fasso

Accountant / Incharge,
Accounting Office

OAS Officer / Incharge

Corresponding
Vice President

Office of the University


President

Supply Officer / Incharge

OAS Officer / Incharge

Accountant / Incharge,
Accounting Office

Corresponding
Vice President

Campus Director

Fasso

For Support Personnel / Non-Teaching Employees


Head / Dean / Director
(Immediate Superior)

Office of the University


President

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