School Form 3 (SF3) Books Issued and Returned

(This replaces Form 1 & Inventory of Textbooks)

School ID 304629 School Year 2021 - 2022

School Name Cotabato City NHS - Rojas #13 Grade Level Grade 8 (Year II) Section CARN
Subject Area: Subject Area: Subject Area: Subject Area & Title / Subject Area: Subject Area: ESP Subject Area: Subject Area MAPEHitle Quarter 1
ENGLISH FILIPINO MATHEMATICS SCIENCE Reference / Title/Module: TLE Module 1
NAME Title/Module: Title/Module: Title/Module: Code Quarter 1 AP Quarter 1 Title/Module:
No Quarter 1 Quarter 1 Quarter 1 Module 1 & Title/Module: Module 1 & 2 Quarter 1
(Last Name, First Name, Middle Module 1 & 2 Module 1 & 2 Module 1 & 2 2 Quarter 1 Reference Code: Module 1 & 2
.
Name) Reference Code:
Date Reference Code:
Date Reference Code:
Date Date Module 1 & 2
Date _____________
Date Reference Code: _____________
Date Date Date
_____________ _____________ _____________ Reference Code: _____________
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

1 ABAS,FAREEZ, KANSI 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

ABDULRAHIM,JOHAIBER,
2 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
KINUDALAN

3 ABPAG,MOHAMMAD, ADZIS 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

4 ACAS,BENIDICK, LICO 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

5 ACOB,NORHAIMEN, MIDTALIN 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

AKONG,ALLADIN, DELOS
6 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
SANTOS
ARUYOD,MOHAMMAD JR,
7 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
SOLAIMAN

8 CHING,PAOLO MILES, - 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

DEOCAMPO,JOSHUA JOHN,
9 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
CACHUELA
GONZALES,PHILIP JAMES,
10 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
BESA

GUIALEL,PRINCE MUHAMMAD 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
11
SAUDI, CALIM

GUILANG,ALMANSOUR,
12 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
GAMAO
IBRAHIM,AL NEESAM,
13 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
MAROHOM

14 KANAKAN,RAYAN, MAULANA 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

15 KARINDA,NAJIB, BUTO 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

16 KUSAIN,MOHAIMEN, MAGUA 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

17 MAS,ARCHIE, ARCADIO

18 MOHAMAD,EMAN, ANAN 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

19 PIÑOSO,RUSTY, TOMAROY 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

20 SAGADAN,DATU ALI, GABATO 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
 CARNATION

REMARKS/ACTION TAKEN
(Please refer to the legend on last
page)
Date
Issued Returned
21 TAHIR,ALADIN, ABDULLAH 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

22 TASIL,SALAHUDIN, LAUBAN 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

23 TUAN,ALNOR, ODIN 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

24 UMPAT,FHAISAL, LATIP 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

ZACARIA,MAHMUD,
25 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
MOHAMMAD

26 ZULUETA,BENEDICT, S 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

26
<=== TOTAL FOR MALE | 26 26 26 26 26 26 26 26 26 26 26 26 26 26 26 26
TOTAL COPIES ===>
BINASING,SARAH BELLE,
1 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
ABAS
BLAH,BAI SITTIE ZAAPHRIA,
2 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
ABUGANTAO
DEOCAMPO,AMELYN,
3 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
CACHUELA
FASOY,SITTIE SHARLOWE,
4 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
TAYUAN

5 GUIAMADEL,BUKA, ESMAEL 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

6 IBRAHIM,ASLEAH, BANTAWI 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

7 KANAKAN,RAISA, MAULANA 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

LUMENDA,NORSAIDA,
8 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21
MOHAMMAD

9 MACMOD,JUMARA, GUIABEL 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

10 MACMOD,ZAHARIA, ABDUL 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

11 OLIVARES,PHRINCESS, REYES 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

12 PATIANG,ALEA, VELASCO 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

13 SANDAY,ROHAINIE, PEREZ 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

14 UDI,MOHAIRA, ABAS 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9 10 2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 10 07 21 9/10/2021 9/10/2021 10 07 21

14
<=== TOTAL FOR FEMALE | 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14
TOTAL COPIES ===>

40
<=== TOTAL LEARNERS | 40 40 40 40 40 40 40 40 40 40 40 40 40 40 40 40
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 to School Property Custodian (for code TDO), PTL=Paid
NASMER KAMSALI BEMBI NAS
by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14, 2.2012. (Signature of Adviser over Printed Name)

Generated thru LIS

ALI BEMBI NAS
over Printed Name)

thru LIS
Date of BoSY:___/___/_____ Date of EoSY: ___/___/____
of EoSY: ___/___/_____