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Republic of the Philippines

Department of Education
Region X – Northern Mindanao
DIVISION OF OZAMIZ CITY
IBJTNo.
Telephone Compound, Carangan,
(088) 545-0988 Fax Ozamiz City
No. (088) 545-0990

Date

CERTIFICATE OF RETURNED ITEMS

This is to certify that I have received the equipments listed below from

of to wit:
Name School

Item Description Qty Unit Used Remarks

Received by: Returned by:


Property Custodian Date Accountable Employee Date

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