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

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
1 ABAS,FAREEZ, KANSI 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

ABDULRAHIM,JOHAIBER, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
2
KINUDALAN 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
3 ABPAG,MOHAMMAD, ADZIS 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
4 ACAS,BENIDICK, LICO 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
5 ACOB,NORHAIMEN, MIDTALIN 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

AKONG,ALLADIN, DELOS 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
6
SANTOS 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

ARUYOD,MOHAMMAD JR, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
7
SOLAIMAN 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
8 CHING,PAOLO MILES, - 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

DEOCAMPO,JOSHUA JOHN, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
9
CACHUELA 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

GONZALES,PHILIP JAMES, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
10
BESA 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
GUIALEL,PRINCE MUHAMMAD 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
11
SAUDI, CALIM

GUILANG,ALMANSOUR, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
12
GAMAO 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

IBRAHIM,AL NEESAM, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
13
MAROHOM 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
14 KANAKAN,RAYAN, MAULANA 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
15 KARINDA,NAJIB, BUTO 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
16 KUSAIN,MOHAIMEN, MAGUA 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

17 MAS,ARCHIE, ARCADIO

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
18 MOHAMAD,EMAN, ANAN 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
19 PIÑOSO,RUSTY, TOMAROY 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
20 SAGADAN,DATU ALI, GABATO 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
21 TAHIR,ALADIN, ABDULLAH 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
22 TASIL,SALAHUDIN, LAUBAN 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
23 TUAN,ALNOR, ODIN 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
24 UMPAT,FHAISAL, LATIP 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

ZACARIA,MAHMUD, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
25
MOHAMMAD 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
26 ZULUETA,BENEDICT, S 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

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, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
1
ABAS 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

BLAH,BAI SITTIE ZAAPHRIA, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
2
ABUGANTAO 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

DEOCAMPO,AMELYN, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
3
CACHUELA 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

FASOY,SITTIE SHARLOWE, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
4
TAYUAN 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
5 GUIAMADEL,BUKA, ESMAEL 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
6 IBRAHIM,ASLEAH, BANTAWI 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
7 KANAKAN,RAISA, MAULANA 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

LUMENDA,NORSAIDA, 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
8
MOHAMMAD 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
9 MACMOD,JUMARA, GUIABEL 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
10 MACMOD,ZAHARIA, ABDUL 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
11 OLIVARES,PHRINCESS, REYES 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
12 PATIANG,ALEA, VELASCO 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
13 SANDAY,ROHAINIE, PEREZ 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202 1/25/202 2/15/202
14 UDI,MOHAIRA, ABAS 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

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: ___/___/_____