School Form 3 (SF3) Books Issued and Returned

(This replaces Form 1 & Inventory of Textbooks)

School ID 107900 School Year 2019 - 2020

School Name DELFIN J. JARANILLA ELEMETARY SCHOOL Grade Level FIVE Section BARZAGA
SUBJECT AREAS AND TITLE
KAALAMAN AT
EDUKASYON HALINANG MASIGLA AT UGALING PILIPINO
ARALING SCIENCE AND JOY IN LEARNING KASANAYAN 21ST CENTURY
NAME ALAB FILIPINO PANGTAHANAN AT UMAWIT AT MALUSOG NA SA MAKABAGONG REMARKS/ACTION TAKEN
PANLIPUNAN BEYOND ENGLISH TUNGO SA MATHLETES (Please refer to the
(Last Name, First Name, Middle Name) PANGKABUHAYAN GUMUHIT KATAWAN PANAHON
KAUNLARAN legend on last page)
Date Date Date Date Date Date Date Date Date Date
Returne Returne Returne Returne Returne Returne Returne Returne Returne Returne
Issued Issued Issued Issued Issued Issued Issued Issued Issued Issued
d d d d d d d d d d
1 CACERES, HARVEY C.
2 CAPILI, JOSIAH ISRAEL C.
3 CARISCAL, JEROME S.
4 CUELLO, JHARED SHEAN O.
5 EVANGELISTA,REY VAN VHALLEN D.
6 GOMEZ, KAEZER
7 MARINDUQUE, ANGELO LOUIS G.
8 MARTILLAN, R-JAY L.
9 QUILLAO, BENCH STEVEN C.
10 RETOMA JR, RAMIR C.
11 RODRIGUEZ, KURT ANGEL Q.
12 SALAMODING, JHON BENEDICT M.
13 TEODORO, JABE KERT A.
14 TOLENTINO, A-JAY D.
15 YUZON, ALLENZ A.
<=== TOTAL FOR MALE | TOTAL COPIES ===>
1 ANTIGA, JENICA ELLA C.
2 APAN, ALEAH E.
3 AUJERO, JAMIEY EILAN E.
4 BARTOLOME, LOVI D.
5 BOQUEO, CARLA JEANE R.
6 CANUEL, ALNEIA S.
7 CAPILI, RHIANE LOISE ALTHEA
8 CHUA, JITHERSEN E.
9 DAYUTA, IZA CHLOE M.
10 DELA PAZ, KRISTEL JOY C.
11 ESCARAN, ZAIAH YSABELLA S.
12 FRIAS, FRINCES JANAIRA V.
13 GUBAT, RAISHA FAITH T.
14 ISULAT, ASTINA LYKA
15 MAGPURI, JOY ANN M.
16 MONTEJO, ALEXA LOUISE V.
17 MORALES, JEDIDIAH T.
18 PADILLA, JAKIZHA EISA LEE F.
19 PASTORIL, DHEMITCHEL CHEN S.
20 PELAYO, JANELLE L.
21 POLDO, CHERRY GHALE R.
22 POLO, ANGELU ZOE M.
23 SALORIA, SHANNEN RAY N.
<=== TOTAL FOR FEMALE | TOTAL COPIES ===>
<=== TOTAL LEARNERS | TOTAL COPIES ===>
In case of lost/unreturned books, please provide information with the Prepared By:
GUIDELINES:
following code:

1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form.
3. The Total Number of Copies issued at BoSY shall be reflected in the form.
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the
form.
5. All textbooks being used must be included. Additional copies of this form may be
used if needed.
A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, LOUGIEBELLE DESINGAÑO DIMAANO
NEG=Negligence
(Signature of Adviser over Printed Name)
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly
signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly
noted by School Head for submission to School Property Custodian (for code TDO),
Generated thru LIS
PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003,
DO#14, 2.2012.
ZAGA

ION TAKEN
refer to the
last page)
 SUBJECT AREAS AND TITLE
KAALAMAN
A. In Column Date Returned, codes are: FM=Force Majeure, TDO:ATTransferred/Dropout,
EDUKASYON HALINANG MASIGLA AT UGALING PILIPINO
ARALING SCIENCE AND
NEG=Negligence JOY IN LEARNING KASANAYAN 21ST CENTURY
NAME ALAB FILIPINO PANGTAHANAN AT UMAWIT AT MALUSOG NA SA MAKABAGONG REMARKS/ACTION TAKEN
PANLIPUNAN BEYOND
B. In Column Remark/Action Taken,ENGLISH TUNGO SA
codes are: LLTR=Secured Letter from Learner duly MATHLETES (Please refer to the
(Last Name, First Name, Middle Name) PANGKABUHAYAN GUMUHIT KATAWAN PANAHON
signed by parent/guardian (for code FM), TLTR=TeacherKAUNLARAN
prepared letter/report duly legend on last page)
noted by School Head for submission to School Property Custodian (for code TDO),
Date Date Date Date Date Date Date Date Date Date
PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003,
Returne Returne Returne Returne Returne Returne Returne Returne Returne Returne
Issued Issued DO#14, 2.2012.
Issued Issued Issued Issued Issued Issued Issued Issued
d d d d d d d d d d
Date of BoSY:___/___/_____ Date of EoSY: ___/___/_____
 School Form 3 (SF3) Books Issued and Returned
(This replaces Form 1 & Inventory of Textbooks)

School ID 107900 School Year 2019 - 2020

School Name DELFIN J. JARANILLA ELEMETARY SCHOOL Grade Level FIVE Section BARZAGA
SUBJECT AREAS AND TITLE REMARKS/
KAALAMAN AT ACTION TAKEN
NAME EDUKASYON HALINANG MASIGLA AT UGALING PILIPINO TOTAL
ARALING SCIENCE AND JOY IN LEARNING KASANAYAN 21ST CENTURY (Please refer to the
(Last Name, First Name, Middle Name) ALAB FILIPINO PANGTAHANAN AT UMAWIT AT MALUSOG NA SA MAKABAGONG BOOKS
legend on last
PANLIPUNAN BEYOND ENGLISH TUNGO SA MATHLETES
PANGKABUHAYAN GUMUHIT KATAWAN PANAHON page)
KAUNLARAN
1 CACERES, HARVEY C. 0 1 0 1 1 1 0 1 0 0 5
2 CAPILI, JOSIAH ISRAEL C. 1 1 1 1 1 0 1 1 1 1 9
3 CARISCAL, JEROME S. 1 1 0 1 1 1 1 1 0 0 7
4 CUELLO, JHARED SHEAN O. 0 1 1 1 1 1 1 1 1 1 9
5 EVANGELISTA,REY VAN VHALLEN D. 1 1 1 1 1 1 1 1 1 1 10
6 GOMEZ, KAEZER 0 1 0 1 1 1 1 1 0 1 7
7 MARINDUQUE, ANGELO LOUIS G. 0 1 0 1 1 1 1 1 0 1 7
8 MARTILLAN, R-JAY L. 0 1 1 1 1 1 1 1 0 0 7
9 QUILLAO, BENCH STEVEN C. 1 1 1 0 1 1 1 1 0 0 7
10 RETOMA JR, RAMIR C. 1 1 1 1 1 0 1 1 0 1 8
11 RODRIGUEZ, KURT ANGEL Q. 1 1 1 1 1 1 1 1 1 0 9
12 SALAMODING, JHON BENEDICT M. 1 1 1 0 1 1 0 1 0 1 7
13 TEODORO, JABE KERT A. 1 1 1 0 1 0 1 1 1 1 8
14 TOLENTINO, A-JAY D. 1 1 1 1 1 1 1 1 1 1 10
15 YUZON, ALLENZ A. 1 1 1 0 1 0 1 1 1 0 7 TRANSFERRED OUT
<=== TOTAL FOR MALE | TOTAL COPIES ===> 10 15 11 11 15 11 13 15 7 9 117
1 ANTIGA, JENICA ELLA C. 1 1 1 1 1 1 1 1 1 0 9
2 APAN, ALEAH E. 0 1 1 1 1 0 0 1 0 1 6
3 AUJERO, JAMIEY EILAN E. 1 1 1 1 1 1 1 1 1 1 10
4 BARTOLOME, LOVI D. 0 1 1 1 1 0 1 1 1 1 8
5 BOQUEO, CARLA JEANE R. 0 1 1 1 1 1 0 1 1 1 8
6 CANUEL, ALNEIA S. 0 1 1 1 1 1 1 1 1 1 9
7 CAPILI, RHIANE LOISE ALTHEA 1 1 1 1 1 0 1 0 1 1 8
8 CHUA, JITHERSEN E. 1 1 1 1 1 1 1 1 1 1 10
9 DAYUTA, IZA CHLOE M. 1 1 1 1 1 1 1 1 1 0 9
10 DELA PAZ, KRISTEL JOY C. 1 1 1 1 1 0 1 1 1 0 8
11 ESCARAN, ZAIAH YSABELLA S. 1 1 1 1 1 0 1 1 1 0 8
12 FRIAS, FRINCES JANAIRA V. 0 1 1 1 1 1 1 1 0 1 8
13 GUBAT, RAISHA FAITH T. 1 1 1 1 1 0 1 1 1 1 9
14 ISULAT, ASTINA LYKA 1 1 1 1 1 1 1 1 1 1 10
15 MAGPURI, JOY ANN M. 1 1 1 1 1 0 1 1 1 1 9
16 MONTEJO, ALEXA LOUISE V. 1 1 1 1 1 1 1 1 1 1 10
17 MORALES, JEDIDIAH T. 0 1 1 1 1 1 1 1 1 1 9
18 PADILLA, JAKIZHA EISA LEE F. 0 1 1 1 1 1 1 1 1 1 9
19 PASTORIL, DHEMITCHEL CHEN S. 1 1 1 1 1 1 1 1 1 0 9
20 PELAYO, JANELLE L. 0 1 1 1 1 1 0 1 1 0 7
21 POLDO, CHERRY GHALE R. 0 1 1 1 1 1 1 1 1 0 8
22 SALORIA, SHANNEN RAY N. 0 1 1 1 1 1 1 1 0 1 8
<=== TOTAL FOR FEMALE | TOTAL COPIES ===> 12 22 22 22 22 15 19 21 19 15 189
<=== TOTAL LEARNERS | TOTAL COPIES ===> 22 37 33 33 37 26 32 36 26 24 306
In case of lost/unreturned books, please provide information with the Prepared By:
GUIDELINES:
following code:

1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form.
3. The Total Number of Copies issued at BoSY shall be reflected in the form.
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the
form.
5. All textbooks being used must be included. Additional copies of this form may be
used if needed.
A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, LOUGIEBELLE DESINGAÑO DIMAANO
NEG=Negligence
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly (Signature of Adviser over Printed Name)
signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly
noted by School Head for submission to School Property Custodian (for code TDO),
Generated thru LIS
PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003,
DO#14, 2.2012.
Date of BoSY:___/___/_____ Date of EoSY: ___/___/_____
ZAGA

ARKS/
CTION TAKEN
ase refer to the
gend on last
page)

NSFERRED OUT
 School Form 3 (SF3) Books Issued and Returned
(This replaces Form 1 & Inventory of Textbooks)

School ID 107900 School Year 2019 - 2020

School Name DELFIN J. JARANILLA ELEMETARY SCHOOL Grade Level FIVE Section BARZAGA
SUBJECT AREAS AND TITLE REMARKS/
KAALAMAN AT ACTION TAKEN
NAME EDUKASYON HALINANG MASIGLA AT UGALING PILIPINO TOTAL
ARALING SCIENCE AND JOY IN LEARNING KASANAYAN 21ST CENTURY (Please refer to the
(Last Name, First Name, Middle Name) ALAB FILIPINO PANGTAHANAN AT UMAWIT AT MALUSOG NA SA MAKABAGONG BOOKS
legend on last
PANLIPUNAN BEYOND ENGLISH TUNGO SA MATHLETES
PANGKABUHAYAN GUMUHIT KATAWAN PANAHON page)
KAUNLARAN
1 CACERES, HARVEY C. 0 1 0 1 1 1 0 1 0 0 5
2 CAPILI, JOSIAH ISRAEL C. 1 1 1 1 1 0 1 1 1 1 9
3 CARISCAL, JEROME S. 1 1 0 1 1 1 1 1 0 0 7
4 CUELLO, JHARED SHEAN O. 0 1 1 1 1 1 1 1 1 1 9
5 EVANGELISTA,REY VAN VHALLEN D. 1 1 1 1 1 1 1 1 1 1 10
6 GOMEZ, KAEZER 0 1 0 1 1 1 1 1 0 1 7
7 MARINDUQUE, ANGELO LOUIS G. 0 1 0 1 1 1 1 1 0 1 7
8 MARTILLAN, R-JAY L. 0 1 1 1 1 1 1 1 0 0 7
9 QUILLAO, BENCH STEVEN C. 1 1 1 0 1 1 1 1 0 0 7
10 RETOMA JR, RAMIR C. 1 1 1 1 1 0 1 1 0 1 8
11 RODRIGUEZ, KURT ANGEL Q. 1 1 1 1 1 1 1 1 1 0 9
12 SALAMODING, JHON BENEDICT M. 1 1 1 0 1 1 0 1 0 1 7
13 TEODORO, JABE KERT A. 1 1 1 0 1 0 1 1 1 1 8
14 TOLENTINO, A-JAY D. 1 1 1 1 1 1 1 1 1 1 10
<=== TOTAL FOR MALE | TOTAL COPIES ===> 9 14 10 11 14 11 12 14 6 9 110
1 ANTIGA, JENICA ELLA C. 1 1 1 1 1 1 1 1 1 0 9
2 APAN, ALEAH E. 0 1 1 1 1 0 0 1 0 1 6
3 AUJERO, JAMIEY EILAN E. 1 1 1 1 1 1 1 1 1 1 10
4 BARTOLOME, LOVI D. 0 1 1 1 1 0 1 1 1 1 8
5 BOQUEO, CARLA JEANE R. 0 1 1 1 1 1 0 1 1 1 8
6 CANUEL, ALNEIA S. 0 1 1 1 1 1 1 1 1 1 9
7 CAPILI, RHIANE LOISE ALTHEA 1 1 1 1 1 0 1 0 1 1 8
8 CHUA, JITHERSEN E. 1 1 1 1 1 1 1 1 1 1 10
9 DAYUTA, IZA CHLOE M. 1 1 1 1 1 1 1 1 1 0 9
10 DELA PAZ, KRISTEL JOY C. 1 1 1 1 1 0 1 1 1 0 8
11 ESCARAN, ZAIAH YSABELLA S. 1 1 1 1 1 0 1 1 1 0 8
12 FRIAS, FRINCES JANAIRA V. 0 1 1 1 1 1 1 1 0 1 8
13 GUBAT, RAISHA FAITH T. 1 1 1 1 1 0 1 1 1 1 9
14 ISULAT, ASTINA LYKA 1 1 1 1 1 1 1 1 1 1 10
15 MAGPURI, JOY ANN M. 1 1 1 1 1 0 1 1 1 1 9
16 MONTEJO, ALEXA LOUISE V. 1 1 1 1 1 1 1 1 1 1 10
17 MORALES, JEDIDIAH T. 0 1 1 1 1 1 1 1 1 1 9
18 PADILLA, JAKIZHA EISA LEE F. 0 1 1 1 1 1 1 1 1 1 9
19 PASTORIL, DHEMITCHEL CHEN S. 1 1 1 1 1 1 1 1 1 0 9
20 PELAYO, JANELLE L. 0 1 1 1 1 1 0 1 1 0 7
21 POLDO, CHERRY GHALE R. 0 1 1 1 1 1 1 1 1 0 8
22 POLO, ANGELU ZOE M. 1 1 1 0 1 0 1 1 1 0 7
23 SALORIA, SHANNEN RAY N. 0 1 1 1 1 1 1 1 0 1 8
<=== TOTAL FOR FEMALE | TOTAL COPIES ===> 13 23 23 22 23 15 20 22 20 15 196
<=== TOTAL LEARNERS | TOTAL COPIES ===> 22 37 33 33 37 26 32 36 26 24 306
In case of lost/unreturned books, please provide information with the Prepared By:
GUIDELINES:
following code:

1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form.
3. The Total Number of Copies issued at BoSY shall be reflected in the form.
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the
form.
5. All textbooks being used must be included. Additional copies of this form may be
used if needed.
A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, LOUGIEBELLE DESINGAÑO DIMAANO
NEG=Negligence
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly (Signature of Adviser over Printed Name)
signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly
noted by School Head for submission to School Property Custodian (for code TDO),
Generated thru LIS
PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003,
DO#14, 2.2012.
Date of BoSY:___/___/_____ Date of EoSY: ___/___/_____
ZAGA

ARKS/
CTION TAKEN
ase refer to the
gend on last
page)
 School Form 3 (SF3) Books Issued and Returned
(This replaces Form 1 & Inventory of Textbooks)

School ID 107900 School Year 2019 - 2020

School Name DELFIN J. JARANILLA ELEMENTARY SCHOOL Grade Level FIVE Section BARZAGA
Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title
KAALAMAN AT
NAME ARALING PANLIPUNAN 5 SCIENCE AND BEYOND ALAB FILIPINO JOY IN LEARNING ENGLISH KASANAYAN REMARKS/ACTION TAKEN (Please
(Last Name, First Name, Middle Name) TUNGO SA KAUNLARAN refer to the legend on last page)

Date Date Date Date Date

Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

1 CACERES, HARVEY C. 3/6/2019

2 CAPILI, JOSIAH ISRAEL C. 3/6/2019
3 CARISCAL, JEROME S. 3/6/2019
4 CUELLO, JHARED SHEAN O. 3/6/2019
5 EVANGELISTA,REY VAN VHALLEN D. 3/6/2019
6 GOMEZ, KAEZER 3/6/2019
7 MARINDUQUE, ANGELO LOUIS G. 3/6/2019
8 MARTILLAN, R-JAY L. 3/6/2019
9 QUILLAO, BENCH STEVEN C. 3/6/2019
10 RETOMA JR, RAMIR C. 3/6/2019
11 RODRIGUEZ, KURT ANGEL Q. 3/6/2019
12 SALAMODING, JHON BENEDICT M. 3/6/2019
13 TEODORO, JABE KERT A. 3/6/2019
14 TOLENTINO, A-JAY D. 3/6/2019
15 YUZON, ALLENZ A. 3/6/2019
<=== TOTAL FOR MALE | TOTAL COPIES ===>
1 ANTIGA, JENICA ELLA C. 3/6/2019
2 APAN, ALEAH E. 3/6/2019
3 AUJERO, JAMIEY EILAN E. 3/6/2019
4 BARTOLOME, LOVI D. 3/6/2019
5 BOQUEO, CARLA JEANE R. 3/6/2019
6 CANUEL, ALNEIA S. 3/6/2019
7 CAPILI, RHIANE LOISE ALTHEA 3/6/2019
8 CHUA, JITHERSEN E. 3/6/2019
9 DAYUTA, IZA CHLOE M. 3/6/2019
10 DELA PAZ, KRISTEL JOY C. 3/6/2019
11 ESCARAN, ZAIAH YSABELLA S. 3/6/2019
12 FRIAS, FRINCES JANAIRA V. 3/6/2019
13 GUBAT, RAISHA FAITH T. 3/6/2019
14 ISULAT, ASTINA LYKA 3/6/2019
15 MAGPURI, JOY ANN M. 3/6/2019
16 MONTEJO, ALEXA LOUISE V. 3/6/2019
17 MORALES, JEDIDIAH T. 3/6/2019
18 PADILLA, JAKIZHA EISA LEE F. 3/6/2019
19 PASTORIL, DHEMITCHEL CHEN S. 3/6/2019
20 PELAYO, JANELLE L. 3/6/2019
21 POLDO, CHERRY GHALE R. 3/6/2019
22 POLO, ANGELU ZOE M. 3/6/2019
23 SALORIA, SHANNEN RAY N. 3/6/2019
<=== TOTAL FOR FEMALE | TOTAL COPIES
===>
<=== TOTAL LEARNERS | TOTAL COPIES ===>
In case of lost/unreturned books, please provide information with the following Prepared By:
GUIDELINES:
code:

1. Title of Books Issued to each learner must be recorded by the class adviser. A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, LOUGIEBELLE DESINGAÑO DIMAANO
2. The Date of Issuance and the Date of Return shall be reflected in the form. NEG=Negligence
(Signature of Adviser over Printed Name)
3. The Total Number of Copies issued at BoSY shall be reflected in the form. B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly noted
5. All textbooks being used must be included. Additional copies of this form may be used if needed. by School Head for submission to School Property Custodian (for code TDO), PTL=Paid by
Generated thru LIS
the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14,
2.2012.
1. Title of Books Issued to each learner must be recorded by the class adviser.
Subject Area & Title A. In Column Date
Subject Area Returned,
& Title codes are: FM=Force Majeure,
Subject Area & Title TDO: Transferred/Dropout,
Subject Area & Title Subject Area & Title
2. The Date of Issuance and the Date of Return shall be reflected in the form. NEG=Negligence KAALAMAN AT
3. The Total Number of Copies issued at BoSY shall be reflected in the
NAME
form. PANLIPUNAN 5
ARALING B. In Column AND
SCIENCE Remark/Action
BEYOND Taken, codes are: LLTR=Secured
ALAB FILIPINO Letter from JOYLearner duly
IN LEARNING ENGLISH KASANAYAN REMARKS/ACTION TAKEN (Please
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly noted
5. (Last Name,
All textbooks Firstmust
being used Name, Middle
be included. Name)copies of this form may be used if needed.
Additional by School Head for submission to School Property Custodian (for code TDO), PTL=Paid by TUNGO SA KAUNLARAN refer to the legend on last page)
Date Date Date Date Date
the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14,
Issued Returned 2.2012.
Issued Returned Issued Returned Issued Returned Issued Returned

Date of BoSY:___/___/_____ Date of EoSY: ___/___/_____

 School Form 3 (SF3) Books Issued and Returned
(This replaces Form 1 & Inventory of Textbooks)

School ID 107900 School Year 2019 - 2020

School Name DELFIN J. JARANILLA ELEMENTARY SCHOOL Grade Level FIVE Section BARZAGA
Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title
EDUKASYON PANGTAHANAN HALINANG UMAWIT AT MASIGLA AT MALUSOG NA UGALING PILIPINO SA
21ST CENTURY MATHLETES
No NAME AT PANGKABUHAYAN GUMUHIT KATAWAN MAKABAGONG PANAHON REMARKS/ACTION TAKEN (Please
. (Last Name, First Name, Middle Name) refer to the legend on last page)

Date Date Date Date Date

Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

1 CACERES, HARVEY C. 3/6/2019

2 CAPILI, JOSIAH ISRAEL C. 3/6/2019
3 CARISCAL, JEROME S. 3/6/2019
4 CUELLO, JHARED SHEAN O. 3/6/2019
5 EVANGELISTA,REY VAN VHALLEN D. 3/6/2019
6 GOMEZ, KAEZER 3/6/2019
7 MARINDUQUE, ANGELO LOUIS G. 3/6/2019
8 MARTILLAN, R-JAY L. 3/6/2019
9 QUILLAO, BENCH STEVEN C. 3/6/2019
10 RETOMA JR, RAMIR C. 3/6/2019
11 RODRIGUEZ, KURT ANGEL Q. 3/6/2019
12 SALAMODING, JHON BENEDICT M. 3/6/2019
13 TEODORO, JABE KERT A. 3/6/2019
14 TOLENTINO, A-JAY D. 3/6/2019
15 YUZON, ALLENZ A. 3/6/2019
<=== TOTAL FOR MALE | TOTAL COPIES ===>
1 ANTIGA, JENICA ELLA C. 3/6/2019
2 APAN, ALEAH E. 3/6/2019
3 AUJERO, JAMIEY EILAN E. 3/6/2019
4 BARTOLOME, LOVI D. 3/6/2019
5 BOQUEO, CARLA JEANE R. 3/6/2019
6 CANUEL, ALNEIA S. 3/6/2019
7 CAPILI, RHIANE LOISE ALTHEA 3/6/2019
8 CHUA, JITHERSEN E. 3/6/2019
9 DAYUTA, IZA CHLOE M. 3/6/2019
10 DELA PAZ, KRISTEL JOY C. 3/6/2019
11 ESCARAN, ZAIAH YSABELLA S. 3/6/2019
12 FRIAS, FRINCES JANAIRA V. 3/6/2019
13 GUBAT, RAISHA FAITH T. 3/6/2019
14 ISULAT, ASTINA LYKA 3/6/2019
15 MAGPURI, JOY ANN M. 3/6/2019
16 MONTEJO, ALEXA LOUISE V. 3/6/2019
17 MORALES, JEDIDIAH T. 3/6/2019
18 PADILLA, JAKIZHA EISA LEE F. 3/6/2019
19 PASTORIL, DHEMITCHEL CHEN S. 3/6/2019
20 PELAYO, JANELLE L. 3/6/2019
21 POLDO, CHERRY GHALE R. 3/6/2019
22 POLO, ANGELU ZOE M. 3/6/2019
23 SALORIA, SHANNEN RAY N. 3/6/2019
<=== TOTAL FOR FEMALE | TOTAL COPIES
===>
<=== TOTAL LEARNERS | TOTAL COPIES ===>
In case of lost/unreturned books, please provide information with the following Prepared By:
GUIDELINES:
code:

1. Title of Books Issued to each learner must be recorded by the class adviser. A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, LOUGIEBELLE DESINGAÑO DIMAANO
2. The Date of Issuance and the Date of Return shall be reflected in the form. NEG=Negligence
(Signature of Adviser over Printed Name)
3. The Total Number of Copies issued at BoSY shall be reflected in the form. B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly noted
5. All textbooks being used must be included. Additional copies of this form may be used if needed. by School Head for submission to School Property Custodian (for code TDO), PTL=Paid by
Generated thru LIS
the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14,
2.2012.
1. Title of Books Issued to each learner must be recorded by the class adviser.
Subject Area & Title A. In Column Date
Subject Area Returned,
& Title codes are: FM=Force Majeure,
Subject Area & Title TDO: Transferred/Dropout,
Subject Area & Title Subject Area & Title
2. The Date of Issuance and the Date of Return shall be reflectedEDUKASYON
in the form. PANGTAHANAN HALINANG UMAWIT AT
NEG=Negligence MASIGLA AT MALUSOG NA UGALING PILIPINO SA
3. The Total Number of Copies issued at BoSY shall be reflected in theAT 21ST CENTURY
duly MATHLETES
No NAME PANGKABUHAYAN
form. B. In Column GUMUHIT
Remark/Action Taken, codes are:KATAWAN
LLTR=Secured Letter from Learner MAKABAGONG PANAHON REMARKS/ACTION TAKEN (Please
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly noted
5.. All textbooks
(Last being
Name, First
mustName, Middle Name) refer to the legend on last page)
used be included. Additional copies of this form may be used if needed. by School Head for submission to School Property Custodian (for code TDO), PTL=Paid by
Date Date Date Date Date
the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14,
Issued Returned 2.2012.
Issued Returned Issued Returned Issued Returned Issued Returned

Date of BoSY:___/___/_____ Date of EoSY: ___/___/_____