CS Form No. 7 Repetto pe Rolans Series of 2018 Bepartment of Curation Rearow x See” _ DIVISION OF CRMAVAM DE ORO CITY DIVISION OFFICE CLEARANCE FORM [|__ PURPOSE Date of Application, TO: (DE! ivision of YAN DE OR‘ I hereby apply for clearance from money, property and work-related accountabilities for: Purpose: O Transfer CO Resignation Ci Other Mode of Separation: Retirement U1 Leave. Please specity. Effectivity/inclusive Period: [SchooVOttice of Assignment: Position/SG/Step: [Il_CLEARANCE FROM WORK-RELATED ACCOUNTABILITIES: ‘We hereby cerlfy that this applicant is cleared of work-related accountabilities from this Unw/Office/Dept ‘Name and Signature of Employee Principal/immediate Supervisor Iit_ CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES Name of Unit/Office/Department cleared | jot, Name of Clearing Officer/Official Signature Fi Administration Sector ‘DARLENE B PATAMINE a. [Provident Fund AO payot TAVERNET MERCADO b, [Supply and Property Procurement and Management Sof OAV Supply Ofear ©__Human Resource Welfare & Assistance ‘AO IV-HRMO ISA BEA SOCORRO M. BORRES Administrative Services Admnieave OffetV “Adin Sardcos iS cia ad a ROMIBLS VALLENTE Budget Accountabilly/GFALICONSO LOAN ‘ADV BUDGET ARNEL A. CALA 2, JACCOUNTING SERVICES: Financial Services ee 2 Library TLANIE AE SIGNO GaRARIAN Library Services 1! ce aa DSTA DERROLD MARL. AVES, PAD. BEPS-HROD a. |Scholarship Services IV_ CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE: LAURENCE EDGARDO A. DEL PUERTO [ATTORNEY I a, internal Affi Office/Legal Affairs Office ‘with pending administrative case _with ongoing investigation (no formal charge yet) IV CERTIFICATION | hereby certty that this employee is cleared of work-related, money and property accountabilities from this agency. This Certification includes no pending administrative case from this agency. Y, PH.D. iene OflicerIn- Charge Office ofthe Schonle Divieian Superintendent Signature over Printed Name of Agency Head Page 1of2