DISTRICT CLEARANCE FOR PUBLIC ELEMENTARY & SECONDARY PUBLIC SCHOOL TEACHERS

SY 2016-2017

Name: __________________________ School: _______________________

Position/Designation: ___________District:
To the School Division Superintendent:
May I have the honor to inform you that I have been cleared of all accountabilities in the school/district
where I am presently assigned and that I am also cleared of all the financial, property accountabilities and other
obligations for SY 2016-2017 as evidence by signatories of the officials concerned:

___________________________
SIGNATURE OVER PRINTED NAME

School Head`s Authorized

Date
OFFICIAL IN-CHARGE PROGRAM ACCOUNTABILITIES /YEAR-END REPORTS Approval/Teachers Signature of
Signed
Compliance In-Charge
- Folder SF 6,4,5,3,2,1, 7 hard W/ Checkers
signatures @ soft, Kinder Xerox Card ,201 -
2cps, LIS online, SchoolSF5 with District
Dist. Statistician/ Checkers signature@SF6 Final Copy,
ICT/SGO School data on Promotions, failures,
- Repeaters @ Balik Aral,SIP Soft, APP soft,
Form 86, IPCRF 2016-17, ESY (Performance
Indicators), e-class record.
- Authorized Contribution and other Reports
- Report on TIP,2Lesson plan/mo. With
strength /weakness(178), PAPS
implementation: Scouting, SSG, Brigada,
District Treasurer
Language Arts, DRRM, Nutrition, Sports,
NGP,GPAK, Inspect. Comm., BAC, List of
school Coordinators
-
Authorized collector for authorized Contributions,
Big Book Utilization/Reproduction, School MPS in all
subjects,Lib. Hub Receipts, SSWRP Accomp. Report,
District Auth. Collector
Report on SEF Utilization,MOOE Utilization, CDR
Picture of Updated transparency Board, SBM Report

BPSTEA, 5 least learned Skills in Eng, Fil, Math,

Teachers association Science, Araling Panlipunan,IV to XI and MTB, Fil,
Treasurer Eng I-III, Analysis of Gaps, Policy recommendation,
Report on Research, Findings
BFP Terminal Report SY 2016-2017, NAT Tracking
3yrs., Tracking of NR, R@ E passers, Report on TA
ADAS II
and mentoring, LAC Report , DLAC Report,
Classroom program 2017-18, ALS Situation In School
Classroom Textbook situation, losses, Furniture,
Report on building to be demolished, School officers
on Teachers association, minutes of meeting,
Delivery Receipts of DCP Package and Science-Math
Equipments
CLEARANCE CERTIFICATE

This is to certify that _________________ of ____________________ELEM. SCHOOL is cleared from all financial, property
accountabilities and other obligations for SY 2016-2017.

________________________________
OIC –office of the ARD, Concurrent Schools Division Superintendent