SAN LORENZO RUIZ SCHOOL SAN LORENZO RUIZ SCHOOL SAN LORENZO RUIZ SCHOOL SAN LORENZO RUIZ

SAN LORENZO RUIZ SCHOOL SAN LORENZO RUIZ SCHOOL SAN LORENZO RUIZ SCHOOL
P.RODRIGUES ST., LAPU-LAPU CITY , CEBU 6015 P.RODRIGUES ST., LAPU-LAPU CITY , CEBU 6015 P.RODRIGUES ST., LAPU-LAPU CITY , CEBU 6015 P.RODRIGUES ST., LAPU-LAPU CITY , CEBU 6015
Tel. No. (032) 340-1067/4151070 Tel. No. (032) 340-1067/4151070 Tel. No. (032) 340-1067/4151070 Tel. No. (032) 340-1067/4151070

CLAIM STUB CLAIM STUB CLAIM STUB CLAIM STUB

( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss )
Requested by: ____________________________ Requested by: ____________________________ Requested by: ____________________________ Requested by: ____________________________
Purpose :________________________________ Purpose :________________________________ Purpose :________________________________ Purpose :________________________________
Cashier’s Remarks: ________________________ Cashier’s Remarks: ________________________ Cashier’s Remarks: ________________________ Cashier’s Remarks: ________________________
Date Received: ____________________________ Date Received: ____________________________ Date Received: ____________________________ Date Received: ____________________________
Claim on: ________________________________ Claim on: ________________________________ Claim on: ________________________________ Claim on: ________________________________
Received by: _____________________________ Received by: _____________________________ Received by: _____________________________ Received by: _____________________________
Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name
___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________
Pls. detach for record purpose Pls. detach for record purpose Pls. detach for record purpose Pls. detach for record purpose
( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss )
Date Received: _____________________ Date Received: _____________________ Date Received: _____________________ Date Received: _____________________
Claim on: __________________________ Claim on: __________________________ Claim on: __________________________ Claim on: __________________________
Received by: _______________________ Received by: _______________________ Received by: _______________________ Received by: _______________________
Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name

SAN LORENZO RUIZ SCHOOL SAN LORENZO RUIZ SCHOOL SAN LORENZO RUIZ SCHOOL SAN LORENZO RUIZ SCHOOL
P.RODRIGUES ST., LAPU-LAPU CITY , CEBU 6015 P.RODRIGUES ST., LAPU-LAPU CITY , CEBU 6015 P.RODRIGUES ST., LAPU-LAPU CITY , CEBU 6015 P.RODRIGUES ST., LAPU-LAPU CITY , CEBU 6015
Tel. No. (032) 340-1067/4151070 Tel. No. (032) 340-1067/4151070 Tel. No. (032) 340-1067/4151070 Tel. No. (032) 340-1067/4151070

CLAIM STUB CLAIM STUB CLAIM STUB CLAIM STUB

( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss )
Requested by: ____________________________ Requested by: ____________________________ Requested by: ____________________________ Requested by: ____________________________
Purpose :________________________________ Purpose :________________________________ Purpose :________________________________ Purpose :________________________________
Cashier’s Remarks: ________________________ Cashier’s Remarks: ________________________ Cashier’s Remarks: ________________________ Cashier’s Remarks: ________________________
Date Received: ____________________________ Date Received: ____________________________ Date Received: ____________________________ Date Received: ____________________________
Claim on: ________________________________ Claim on: ________________________________ Claim on: ________________________________ Claim on: ________________________________
Received by: _____________________________ Received by: _____________________________ Received by: _____________________________ Received by: _____________________________
Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name
___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________
Pls. detach for record purpose Pls. detach for record purpose Pls. detach for record purpose Pls. detach for record purpose
( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss ) ( Reminder: Lost CLAIM STUB have to secure Notarized Affidavit of Loss )
Date Received: _____________________ Date Received: _____________________ Date Received: _____________________ Date Received: _____________________
Claim on: __________________________ Claim on: __________________________ Claim on: __________________________ Claim on: __________________________
Received by: _______________________ Received by: _______________________ Received by: _______________________ Received by: _______________________
Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name
 SAN LORENZO RUIZ SCHOOL
P.RODRIGUES ST., LAPU-LAPU CITY , CEBU 6015
Tel. No. (032) 340-1067/4151070

REQUIREMENTS FOR REQUESTING STUDENT’S REQUIREMENTS FOR DUPLICATE COPY OF HIGH

PERMANENT RECORD (F-137) SCHOOL DIPLOMA

 Check your account balance in Accounting Section  Check your account balance in Accounting Section
 Request Form from the School Principal/Registrar for school purposes  Letter Request ( Indicate the year of graduation or year last attended
 Letter Request from the employer/agency for employment purposes and contact number)
 Letter Request from the owner attached with photocopy of DFA  Notarized Affidavit of Loss
Application Form for getting passport. ( Indicate the year of  Payment from Cashier
graduation or year last attended and contact number)
 Payment from Cashier
PROCEDURE :
REQUIREMENTS FOR CORRECTING DATA OF SCHOOL  Submit Requirements to the Records In-Charge
RECORDS  Secure claim stub from the Records In-Charge.
 Come back on the given date.
 Check your account balance in Accounting Section
 Sign the Record Book.
 Letter Request( Indicate the year of graduation or year last attended
and contact number)
 Affidavit of Discrepancy Days in Processing your Request :
 Original and photocopy of Birth Certificate
 REQUESTING STUDENT’S PERMANENT RECORD (F-137) - 5
REQUIREMENTS FOR AUTHENTICATION OF SCHOOL working days upon received
RECORDS  FOR CORRECTING DATA OF SCHOOL RECORDS -5 working
days upon received
 Letter Request ( Indicate the year of graduation or year last attended  FOR DUPLICATE COPY OF HIGH SCHOOL DIPLOMA- depends on
and contact number) the availability of signatory from DEPED Division Office.
 CAV Form (from DEPED Office)  FOR AUTHENTICATION OF SCHOOL RECORDS - 5 working days
 Original and photocopy of Diploma upon received
 Check your account balance in Accounting Section