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 CARNATION
Subject Area: Subject Area: Subject Area: Subject Area & Title / Subject Area: Subject Area: Subject Area: Subject Area
ENGLISH FILIPINO MATHEMATICS SCIENCE Reference / ESP TLE MAPEHitle Quarter 1
NAME Title/Module: Title/Module: Code Quarter 1 AP Title/Module: Title/Module: Module 1
No Title/Module: Quarter 1 Module 5 & 6 Title/Module: Quarter 1 Quarter 1 Module 5 & 6 REMARKS/ACTION TAKEN
(Last Name, First Name, Middle Quarter 1 Quarter 1 Module 5 & 6 Module 5 & 6
(Please refer to the legend on last
. page)
Name) Module 5 & 6
Date Date Module Module 5 & 6
Date Date Quarter 1
Date Date Reference Code: _____________
Date Reference Date Date Date
Reference Code: 5&6 Reference Code: Module 5 & 6 Code: _____________
_____________
Issued Returned Reference Code:
Issued Returned _____________
Issued Returned Issued Returned Issued Reference
Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned
_____________ Code: _____________
10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
1 ABAS,FAREEZ, KANSI 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

ABDULRAHIM,JOHAIBER, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

2 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
KINUDALAN 21 21 2021 21 21 21 21 21 21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

3 ABPAG,MOHAMMAD, ADZIS 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

4 ACAS,BENIDICK, LICO 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

5 ACOB,NORHAIMEN, MIDTALIN 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

AKONG,ALLADIN, DELOS 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
6 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
SANTOS 21 21 2021 21 21 21 21 21 21 2021

ARUYOD,MOHAMMAD JR, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
7 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
SOLAIMAN 21 21 2021 21 21 21 21 21 21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

8 CHING,PAOLO MILES, - 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

DEOCAMPO,JOSHUA JOHN, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
9 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021
CACHUELA
GONZALES,PHILIP JAMES, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
10 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021
BESA
10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
GUIALEL,PRINCE MUHAMMAD 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021
11
SAUDI, CALIM

GUILANG,ALMANSOUR, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

12 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
GAMAO 21 21 2021 21 21 21 21 21 21 2021

IBRAHIM,AL NEESAM, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
13 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
MAROHOM 21 21 2021 21 21 21 21 21 21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

14 KANAKAN,RAYAN, MAULANA 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

15 KARINDA,NAJIB, BUTO 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

16 KUSAIN,MOHAIMEN, MAGUA 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

17 MAS,ARCHIE, ARCADIO

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

18 MOHAMAD,EMAN, ANAN 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

19 PIÑOSO,RUSTY, TOMAROY 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

20 SAGADAN,DATU ALI, GABATO 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021
 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
21 TAHIR,ALADIN, ABDULLAH 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

22 TASIL,SALAHUDIN, LAUBAN 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

23 TUAN,ALNOR, ODIN 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

24 UMPAT,FHAISAL, LATIP 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

ZACARIA,MAHMUD, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

25 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
MOHAMMAD 21 21 2021 21 21 21 21 21 21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

26 ZULUETA,BENEDICT, S 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

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, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
1 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
ABAS 21 21 2021 21 21 21 21 21 21 2021

BLAH,BAI SITTIE ZAAPHRIA, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
2 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
ABUGANTAO 21 21 2021 21 21 21 21 21 21 2021

DEOCAMPO,AMELYN, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

3 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
CACHUELA 21 21 2021 21 21 21 21 21 21 2021

FASOY,SITTIE SHARLOWE, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11
4 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
TAYUAN 21 21 2021 21 21 21 21 21 21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

5 GUIAMADEL,BUKA, ESMAEL 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

6 IBRAHIM,ASLEAH, BANTAWI 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

7 KANAKAN,RAISA, MAULANA 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

LUMENDA,NORSAIDA, 10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

8 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021 11/11/2021
MOHAMMAD 21 21 2021 21 21 21 21 21 21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

9 MACMOD,JUMARA, GUIABEL 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

10 MACMOD,ZAHARIA, ABDUL 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

11 OLIVARES,PHRINCESS, REYES 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

12 PATIANG,ALEA, VELASCO 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

13 SANDAY,ROHAINIE, PEREZ 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

10/28/20 10/28/20 11 11 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 10/28/20 11 11

14 UDI,MOHAIRA, ABAS 21
11/11/2021
21 2021 21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21
11/11/2021
21 2021

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

Generated thru LIS

Date of BoSY:___/___/_____ Date of EoSY: ___/___/_____