Republic of the Philippines

Department of Education
Region VII,Central Visayas
DIVISION OF NEGROS ORIENTAL
AYUNGON I DISTRICT
TEACHER'S CLEARANCE

Name: MARY ERICA FLOR C. SUAREZ School: MABATO PCHS

Position/Designation: SST - 1 District: AYUNGON 1

Sir/Madam:
I have the honor to inform your good office that I have accounted all money and property responsibilities in
the District of Ayungon I and that all reports required of me have been accomplished and duly submitted to the
office of the School Head as indicated below and I already request for CLEARANCE.
AUTHORIZED
FORMS & REPORTS IN-CHARGE SIGNATURE DATE SIGNED
1 Form 86 MARYVEN H. ANITO
2 SF 1, 4,5 & 6 RICHE P. RIZALDO
3 IPCRF ( 2 copy ) School Head
ADTEA Membership/Fund JUVILEOMIE A. BAYLOSIS
Sinking Fund
4
Fiesta Funds ROSELIN L. ALMENZO
DepEd Queen Tickets
5 District T-Shirt MUHAMMAD NASSIF D. ARANI

Very truly yours,

MARY ERICA FLOR C. SUAREZ

Signature Over Printed Name
RECOMMENDING APPROVAL:

______________________________________ APPROVED:
Printed Name & Signature of School Head
MENCHU T. SANTOS,Ed.D
District Caretaker
 Republic of the Philippines
Department of Education
Region VII,Central Visayas
DIVISION OF NEGROS ORIENTAL
AYUNGON I DISTRICT
SCHOOL HEAD'S CLEARANCE
Name: ROSELIN L. ALMENZO School: TAMPOCON I ELEMENTARY SCHOOL
Position/Designation: PRINCIPAL I District: AYUNGON I

To the District In Charge

May I have the honor to inform you that I have been cleared of all accountabilities in the school
where I am presently assigned and I am also cleared of the financial, property accountabilities
and other obligations for SY 2017-2018 as evidenced by the signatures of the officials concerned.

_______________________________
Signature
Program Accountabilities/Year-End Authorized
No. In Charge Date Signed
Reports Signature
1 Liquidation Report
2 Renewal of Fidelity Bond
Updated Inventory of Properties
1. Form 66
2. Form 73
3 MOISES NOBLEFRANCA III
3. List of Donated Properties
4. Payment of Book losses
5. Inventory Custodian Slip
4 Summary of IPCRF- hard & soft copy MENCHU T. SANTOS
1. Form 86 ( with chest x-ray, urinalysis)
2. Endline Nutritional Status ( SY 2017-2018)
5 Maryven H. Anito
3. PPAN & SBFP Terminal Report
4. 2nd Dose Deworming
6 SF 5, SF 6, SFCR 1 MARICHU T. CAPILLA
7 ADTEA JUVILLEOME A. BAYLOSIS
7 Sinking Fund ROSELIN L. ALMENZO
Very truly yours, APPROVED:

_________________________ LYDIA V. BENSON, Ph.D.

Signature Over Printed Name District In Charge