Republika ng Pilipinas

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

TEACHER'S CLEARANCE

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 PTA Fund

DepEd Form 2 Pupil's Fund
DepEd Form 18-E-1/18-E-2 BSP Fund
DepEd Form 137-E GSP Fund
DepEd Form 138-E Anti-TB
DepEd 112 (Prop. Shortages) Jr. Red Cross
DepEd 113 Sr. Red Cross
C.S. Form 48 FHP
Property Inventory PPSTA Eff. Date Membership
Elem. Certificate 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: Very truly yours,

CRISTELYN M. FELIX
Principal I Teacher
Unang Paglipat
Purok ng Sta. Ana
Lungsod ng Dabaw

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 LEONORA CABAÑOG

Guidance In - Charge Teachers' Club Treasurer

ELADIO I. PUERTOS JR.

Grade Head Property Custodian

NANCY BEQUISO
Teacher's Club President

PAST
Form In - Charge Grade Head

JEANNE DEOCAMPO
SANTADISTA Treasurer

fn://acer-aspire-m1201/mares/iceman9/Teachers-Clearance.xls
 epublika ng Pilipinas
gawaran ng Edukasyon
REHIYON XI
ay ng Lungsod ng Dabaw
UROK NG STA. ANA
Lungsod ng Dabaw

ACHER'S CLEARANCE