CS Form No.

7
Series of 2017

DEPARTMENT OF EDUCATION
CLEARANCE FORM

I PURPOSE

Date of Application
TO: DEPARTMENT OF EDUCATION
I hereby apply for clearance from money, property and work-related accountabilities for:
Purpose: Transfer Resination Other Mode of Separation:
Retirement Leave Please specify: ______________

Effectivity/Inclusive Period: ________________________________________________________

BENJAMIN VELASCO BAUTISTA SR. NATIONAL HIGH

Office of Assignment: SCHOOL
_________________________________
Position/SG/Step: Name and Signature of Employee

II CLEARANCE FROM WORK-RELATED ACCOUNTABILITIES

I/We hereby certify that this applicant is cleared of all work-related accountabilities from this Unit/Office/Dept.

EUFEMIA C. CAMAHALAN
School Head
III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES
Name of Clearing Officer/Official
Name of Unit/Office/Department Cleared Not Cleared
1 Administration Sector

Supply and Property Procurement and a.

Management Services CARLO P. MAÑEGO

b. Human Resource Welfare & Assistance ARPEE MAE D. ALICARTE

c. Agency-accredited Union/Cooperative FORTUNATO D. CAMAHALAN

2 Classroom/Offices Properties

a. Classroom Properties SOLLY V. CAMEROS

b. Library Services LYZA MAE J. MATURAN

3 Finance and Assets Management

a. Financial Services LIRMA JOY R. ESCALANTE

Transaction, Processing & Billing b.

Services NEIL GRACE F. MARIANO

C. School Canteen JASMIN S. CAMPANER

4 Professional and Institutional Development

a. Scholarship Services
IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:
Internal Affairs Officer/Legal Affairs
a. Office

with pending administrative case

with ongoing investigation (no formal charge yet)

V CERTIFICATION

EUFEMIA C. CAMAHALAN
School Head
 Date of Application

ode of Separation:
ecify: ______________

__________________
nature of Employee

C. CAMAHALAN
ool Head

Signature
CS Form No. 7
Series of 2017

DEPARTMENT OF EDUCATION
CLEARANCE FORM

I PURPOSE

Date of Application
TO: DEPARTMENT OF EDUCATION
I hereby apply for clearance from money, property and work-related accountabilities for:
Purpose: Transfer Resination Other Mode of Separation:
Retirement Leave Please specify: ______________

Effectivity/Inclusive Period: ________________________________________________________

BENJAMIN VELASCO BAUTISTA SR. NATIONAL HIGH

Office of Assignment: SCHOOL
_________________________________
Position/SG/Step: Name and Signature of Employee

II CLEARANCE FROM WORK-RELATED ACCOUNTABILITIES

I/We hereby certify that this applicant is cleared of all work-related accountabilities from this Unit/Office/Dept.

EUFEMIA C. CAMAHALAN
School Head
III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES
Name of Clearing Officer/Official
Name of Unit/Office/Department Cleared Not Cleared
1 Administration Sector
RUDITO E. DOMINGO
Supply and Property Procurement and a. AO IV-SUPPLY
Management Services OFFICER
ELAINE HAZEL M. DONASCO
OIC-AO IV -
b. Human Resource Welfare & Assistance PERSONNEL SECTION

c. Agency-accredited Union/Cooperative N/A

2 Library

a. Legal Office Library N/A

b. Library Services N/A

3 Finance and Assets Management
QUEEN ANNE R. ALBOROTO, CPA
OIC
a. Financial Services ACCOUNTANT
QUEEN ANNE R. ALBOROTO, CPA
Transaction, Processing & Billing b. ADAS III/OIC
Services ACCOUNTANT
BERNIE L. OCTURA
c. Payroll & Remittance Services AO IV-CASHIER
4 Professional and Institutional Development

WINNIE P. MOVANAS
a. Scholarship Services SEPS - HRO
IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:
Internal Affairs Officer/Legal Affairs
a. Office

with pending administrative case

with ongoing investigation (no formal charge yet)

V CERTIFICATION

REYNALDO B. MELLORIDA
Schools Division Superintendent
 Date of Application

ode of Separation:
ecify: ______________

__________________
nature of Employee

C. CAMAHALAN
ool Head

Signature