Republic of the Philippines

Department of Education
MIMAROPA Region
SCHOOLS DIVISION OF PALAWAN
PEO Road, Bancao-Bancao
Puerto Princesa City
I PURPOSE

Date of Application
TO: DEPED SDO-PALAWAN
I hereby apply for clearance from money, property and work-related accountabilities for:
Purpose: Transfer Resignation Other Mode of Separation:
Retirement Leave Please specify: ____________________
Effectivity/Inclusive Period: ___________________________________________

Office of Assignment: ________________________________

Position/SG/Step: ___________________________________ Name and Signature of Employee

II CLEARANCE FROM WORK-RELATED ACCOUNTABILITIES
We hereby certify that this applicant is cleared of work-related accountabilities from this Unit/Office/Dept.

ELSIE T. BARRIOS, PhD

Immediate Supervisor Head of Office
III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES
Not Name of Clearing
Name of Unit/Office/Department Cleared Signature
Cleared Officer/Official
1. Administration Sector
Supply and Property Procurement and
DOROTHY C. DELLOSA
a. Management Services

b.Human Resource Welfare & Assistance SHERYL B. LAGRADA

c. Agency-accredited Union/Cooperative ISABELITA A. SAMPAYAN

2. Library

a. Legal Office Library NOT APPLICABLE

b. Library Services GRACE P. CANTO

3. Finance and Assets Management

a. Financial Services CHITA D. UMALI

b.Transaction, Processing & Billing Services ISABELITA A. SAMPAYAN

c. Payroll & Remittance Services NOT APPLICABLE

4. Professional and Institutional Development

a. Scholarship Services NOT APPLICABLE

IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:

a. Internal Affairs Office/Legal Affairs Office ATTY. JOSHUA L. ABRINA

with pending administrative case
with ongoing investigation (no formal charge yet)
V CERTIFICATION
I hereby certify that this employee is cleared of work-related, money and property accountabilities from this agency.
This certification includes no pending administrative case from this agency.

ELSIE T. BARRIOS, PhD

Signature over Printed Name of Agency Head

Page 1 of 2 aa
Page 2 of 2 aa