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
Title/Module: Title/Module: Code Quarter 2 AP Title/Module: Title/Module: Module 2
Title/Module: Quarter Module 1 & Quarter 2 Quarter 2 Module 5 & 6
NAME Quarter 2 Quarter 2 2 2 Title/Module: Module 1 & Module
No Module 1 & 2 Module Module 1 & 2 Quarter 2 2 1&2 REMARKS/ACTION TAKEN
(Last Name, First Name, Middle (Please refer to the legend on last
. Reference 1&2 Reference Module Reference Code: Reference Code: page)
Name) Code: _____________ Reference Code: Code: _____________ 1&2 _____________ _____________
_____________ Reference Code:
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

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
1 ABAS,FAREEZ, KANSI 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

ABDULRAHIM,JOHAIBER, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
2
KINUDALAN 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
3 ABPAG,MOHAMMAD, ADZIS 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
4 ACAS,BENIDICK, LICO 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
5 ACOB,NORHAIMEN, MIDTALIN 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

AKONG,ALLADIN, DELOS 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
6
SANTOS 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

ARUYOD,MOHAMMAD JR, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
7
SOLAIMAN 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
8 CHING,PAOLO MILES, - 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

DEOCAMPO,JOSHUA JOHN, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
9
CACHUELA 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

GONZALES,PHILIP JAMES, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
10
BESA 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
GUIALEL,PRINCE MUHAMMAD 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022
11
SAUDI, CALIM

GUILANG,ALMANSOUR, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
12
GAMAO 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

IBRAHIM,AL NEESAM, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
13
MAROHOM 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
14 KANAKAN,RAYAN, MAULANA 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
15 KARINDA,NAJIB, BUTO 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
16 KUSAIN,MOHAIMEN, MAGUA 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

17 MAS,ARCHIE, ARCADIO

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
18 MOHAMAD,EMAN, ANAN 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
19 PIÑOSO,RUSTY, TOMAROY 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
20 SAGADAN,DATU ALI, GABATO 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
21 TAHIR,ALADIN, ABDULLAH 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022
 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
22 TASIL,SALAHUDIN, LAUBAN 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
23 TUAN,ALNOR, ODIN 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
24 UMPAT,FHAISAL, LATIP 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

ZACARIA,MAHMUD, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
25
MOHAMMAD 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
26 ZULUETA,BENEDICT, S 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

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, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
1
ABAS 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

BLAH,BAI SITTIE ZAAPHRIA, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
2
ABUGANTAO 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

DEOCAMPO,AMELYN, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
3
CACHUELA 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

FASOY,SITTIE SHARLOWE, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
4
TAYUAN 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
5 GUIAMADEL,BUKA, ESMAEL 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
6 IBRAHIM,ASLEAH, BANTAWI 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
7 KANAKAN,RAISA, MAULANA 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

LUMENDA,NORSAIDA, 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
8
MOHAMMAD 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
9 MACMOD,JUMARA, GUIABEL 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
10 MACMOD,ZAHARIA, ABDUL 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
11 OLIVARES,PHRINCESS, REYES 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
12 PATIANG,ALEA, VELASCO 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
13 SANDAY,ROHAINIE, PEREZ 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 111 11/23/20 1 1 1
14 UDI,MOHAIRA, ABAS 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022 21 2022

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
NASMER KAMSALI BEMBI NAS
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:___/___/_____ Date of EoSY: ___/___/_____