Department of Education

Region VI-Western Visayas

Division of Negros Occidental
DISTRICT OF MURCIA II

TEACHER’S YEAR END CLEARANCE

SY 2018-2019

_____________________________
Date
The Schools Division Superintendent
Division of Negros Occidental
Cottage Road, Bacolod City

Madam:

I have the honor to inform you that I have satisfactorily accounted all money and property responsibilities for which I
was responsible in this district and that all reports and collections listed below are submitted on the date specified.
REPORTS DATE SUBMITTED RECEIVED BY SIGNATURE
1. SF 1 ________________ School Head ________________
2. SF 5 ________________ - do - ________________
3. SF 2, Form6 Form 48 ________________ - do - ________________
4. Form 137E/ 138 ________________ - do - ________________
5. Orientation List I-V) ________________ - do - ________________
6. School Subject Coordinators Report ________________ - do - ________________
7. IPRCRF with MOV’s ________________ - do - ________________
8. Update 201 file
- Appointment (all)
- Updated Service Record
- Form 212 w/ ID Picture
- PDF
- Teachers Profile ________________ - do - ________________
9. Form 86 ________________ - do - ________________
10. Classroom ready ( clean, well arranged)
for occupancy ________________ - do - ________________
11. School League Funds/ Dues ________________ School Treasurer ________________
12. District League Funds/ Dues ________________ District Treasurer ________________
13. Cleared as to School League Dues/
Other Contributions ________________ School Treasurer ________________
14. Cleared as to School Property
Custodian ________________ School Property Custodian ________________

Name of Teacher: ANALYN F. QUIATCHON

School: AMAYCO ELEMENTARY SCHOOL
Address: BRGY. ABU-ABU, MURCIA, NEGROS OCCIDENTAL
Contact Number: 09129828326
__________________________________________________________________________________________________

1st Endorsement
District of Murcia II
Respectfully forwarded to the Schools Division Superintendent, Cottage Road, Bacolod City, the here in Clearance
of Money and Property Responsibilities of ANALYN F. QUIATCHON, whose last day of service in this District was
__________________________. The foregoing statements are true and correct and complete clearance is hereby
recommended.
JULY C. BAYUDANG
School Head
Recommending Approval:

MYLINE A. CORNEL, PhD Approved:

District Supervisor , CHERYL J. TONDO, PhD
Principal III
In-charge of North Negros