School Form 3 (SF3) Books Issued and Returned

(This replaces Form 1 & Inventory of Textbooks)

School ID 105795 School Year 2021 - 2022

School Name Burnay ES Grade Level Grade 6 Section VENUS

FILIPINO 6 ENGLISH 6 MATH 6 SCIENCE 6 AP 6 ESP 6 EPP 6 Music & Arts PE & Health Subject Area & Title /
Module / Reference /
NAME Code
No
(Last Name, First Name, Middle
.
Name) Date Date Date Date Date Date Date Date Date Date
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

BATADISTA,RUEL JR, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 09-13- 06-24-2022 09-13-2021 06-24-2022
1 9 2021
CONSTANTINO -
1
BUENO,DON DON, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0
3 09-13- 06-24-2022 09-13-2021 06-24-2022
2 9
- 2021
MACADANGDANG -2
1
CONSTANTINO,MARVIN, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 03 09-13- 06-24-2022 09-13-2021 06-24-2022
3 2
9
-1 2021
PURGANAN -2
1
09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 09-13- 06-24-2022 09-13-2021 06-24-2022
4 DELA CRUZ,ARVIE, CORPUZ 2
9
-1 2021
-2
1
09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 09-13- 06-24-2022 09-13-2021 06-24-2022
5 ESTEBAN,JAMES, VALDEZ 2
9
-1 2021
-2
1
EVANGELISTA,ADRIAN, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 09-13- 06-24-2022 09-13-2021 06-24-2022
6 2
9
-1 2021
CASTILLO -2
1
GALICIA,JONH IVAN, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 09-13- 06-24-2022 09-13-2021 06-24-2022
7 2
9
-1 2021
SANTOYO -2
1
MANUEL,SIDMAR BRYAN, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 09-13- 06-24-2022 09-13-2021 06-24-2022
8 2
9
-1 2021
RAMOS -2
1
MARTIN,CHRISTIAN, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 09-13- 06-24-2022 09-13-2021 06-24-2022
9 2
9
-1 2021
SALVADOR -2
1
MORALES,JOHN MARK, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 09-13- 06-24-2022 09-13-2021 06-24-2022
10 2 2021
9
TIONGSON -1
-2
1
0 09-13-
09-13-2021 06-24-2030 09-13-2021 06-24-2022 09-13-2021 06-24-2030 09-13-2021 06-24-2030 09-13-2021 06-24-2030 09-13-2021 06-24-2030 09-13-2021 06-24-2030 0 3 06-24-2022 09-13-2021 06-24-2022
11 PAGUIO,TROY, MORALES 2
9
-1 2021
-2
1
0 09-13-
PASCUA,KURT JERICHO, DELA 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 06-24-2022 09-13-2021 06-24-2022
12 2 2021
9
CRUZ -1
-2
1
0 09-13-
09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 06-24-2022 09-13-2021 06-24-2022
13 RONQUILLO,DON JOHN FIEL, - 2
9
-1 2021
-2
1
VALDEZ,CHRIS JOHN, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 09-13- 06-24-2022 09-13-2021 06-24-2022
14 2 2021
9
MAGAYO -1
-2
1
09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 09-13- 06-24-2022 09-13-2021 06-24-2022
15 VICENTE,JHON MARK, BERDIN 2
9
-1 2021
-2
1
VILLALONA,JAN ERNIE, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 0 3 09-13- 06-24-2022 09-13-2021 06-24-2022
16 2 2021
9
PARAISO -1
-2
1
0
16
<=== TOTAL FOR MALE | 16 16 16 16 16 16 16 16 16 16 16 16 16 16
3
2 16 16 16 16
TOTAL COPIES ===> -1
2
CABANILLA,DAISY MAY, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 009-13-2021 06-24-2022 09-13-2021 06-24-2022
1 2
ALIMBANGO 1
09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
2 CABISO,LYKA, DE LEON

09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
3 ERRUA,CARLA JOY, MATIC

09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
4 ESTEBAN,CAMILE, BALAJADIA
VENUS

REMARKS/ACTION TAKEN
(Please refer to the legend on last
page)
 MIRANDA,SOFHIA BIANCA, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
5
FLORES
09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
6 PADILLA,KYLA, CORPUZ

PAGADUAN,LORAINE JOY, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
7
VIERNES
PAJELA,MA. PAULENE, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
8
REDOBLADO
RAYMONDA,JEICY MAE, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
9
VERGARA
09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
10 SANTOS,CECILIA, MATA

09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
11 SANTOS,MICKIE, HERNANDEZ

09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
12 TAMAYO,TYRHA, DAMACIO

TODIÑO,EMERALD JOY, 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022 09-13-2021 06-24-2022
13
CORPUZ

13
<=== TOTAL FOR FEMALE | 13 13 13 13 13 13 13 13 13 13 13 13 13 13 13 13 13 13
TOTAL COPIES ===>

29
<=== TOTAL LEARNERS | 29 29 29 29 29 29 29 29 29 29 29 29 29 29 29 29 29 29
TOTAL COPIES ===>
Prepared By:
GUIDELINES: In case of lost/unreturned books, please provide information with the following code:

1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form.
3. The Total Number of Copies issued at BoSY shall be reflected in the form.
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form.
5. All textbooks being used must be included. Additional copies of this form may be used if
needed.
A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by
parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission
ERIKA MARIE DELFIN SANTOS
to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code NEG). References: DO#23, (Signature of Adviser over Printed Name)
s.2001, DO#25, s.2003, DO#14, 2.2012.

Generated thru LIS

Date of BoSY:09/13/2021 Date of EoSY: 06/24/2022

ARIE DELFIN SANTOS
of Adviser over Printed Name)

Generated thru LIS

e of EoSY: 06/24/2022