Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IV-A (CALABARZON)
Division of Rizal
PAG-ASA NATIONAL HIGH SCHOOL
Victoria Village, Pag-asa Binangonan, Rizal

BORROWER’S SLIP
Borrower’s Name: _ _ Date:
Position: _ _ Purpose: _

Condition of
the Item Condition of
Item/s (Include Borrowed the Item
Quantity the specifications of Borrowed after
Date before Date
(Item the item/s Borrowing
Borrowed Borrowing Returned
Borrowed) borrowed)
(Good Condition, (Good Condition,
i.e. 14 inches LG Monitor With Damages-
With Damages-
indicate damages) indicate damages)

Notes:

• Teachers can use the borrowed items to attend to online training courses and
conduct online classes for their students using tools such as the DepEd
commons, LR portal, and other websites during situations when face-to-face instructions
is no longer possible due to quarantine restrictions brought about by the COVID-19
pandemic.
• The teacher is liable for any loses or damages while the device/borrowed
material/s in in their custody if it is determined that there was negligence on the part of
the teacher.
• Teachers are required to return the said devices upon resumption of regular
classes.
• The items to be borrowed will be subjected to ACTUAL AVAILABILITY OF THE
ITEMS. Items will be allowed to be borrowed by the teachers provided that the skeletal
work force of the school (i.e. Registrar, LIS/EBEIS Coordinator, School Property
Custodian, Liaison Officer, other related tasks) are not affected or will not use the item
to be borrowed.
• Likewise, borrowing of items shall also be subjected also to the available items at
the school should other teachers wish to report and use the said item at school.

_
Printed Name and Signature of the Borrower

Checked by: Noted by:

CRISTIAN G. PORTUGAL ALLAN C. DILAGAN

School Property Custodian School Head