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Report of Lost, Stolen, Damaged or Destroyed Property: Appendix 75

The document reports the loss of a laptop issued by Balibago Integrated High School. The laptop, an Acer Travelmate TMPZ45-G2-MG, was lost by the late husband of its holder. It was misplaced and got lost last November 2018. The accountable officer certified that the circumstances stated are true and correct.

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3K views

Report of Lost, Stolen, Damaged or Destroyed Property: Appendix 75

The document reports the loss of a laptop issued by Balibago Integrated High School. The laptop, an Acer Travelmate TMPZ45-G2-MG, was lost by the late husband of its holder. It was misplaced and got lost last November 2018. The accountable officer certified that the circumstances stated are true and correct.

Uploaded by

Knoll Viado
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Appendix 75

REPORT OF LOST, STOLEN, DAMAGED OR DESTROYED PROPERTY

Entity Name : BALIBAGO INTEGRATED HIGH SCHOOL Fund Cluster: SEF


Department/Office : BIHS- COMPUTER LAB. 2 RLSDDP No. : ______________
Accountable Officer: ERMA S, JAMON, Ed.D. RLSDDP Date : _____________
Designation : ICT- COORDINATOR PAR No. : IT-2018-06
Police Notified : Yes Police Station : ____________________ PAR Date : June 6, 2018
Date : ___________________________
No

Status of Property : (check applicable box)


Lost Damaged
Stolen Destroyed

Property No. Description Acquisition Cost

IT-2018-06 Laptop Acer Travelmate TMPZ45-G2-MG 30,638.07

Circumstances:

The surviving wife of the late MARK LESTER P. HERNANDEZ, who was the
keeper/holder a Laptop Acer Travelmate issued by the Balibago Integrated High School, Santa
Rosa, Laguna that last November 2018, the said item was misplaced and got lost.

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I hereby certify that the item/s and circumstances stated above are true
and correct. Noted by:

ERMA S. JAMON, Ed.D. __________________________________


Signature over Printed Name of the Accountable Officer Signature over Printed Name of the Immediate
Supervisor
November 22, 2018 ________________
Date Date

Government Issued ID : __________________


ID No. : _____________________________
Date Issued : _________________________

SUBSCRIBED AND SWORN to before me this ______day of _____________, affiant exhibiting the above
government issued identification card.

Doc. No. _________


Page No. _________ Notary Public
Book No. _________
Series of _________

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