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Clearance Form: Edwin R. Maribojoc, Edd, Ceso Vi

This document is a clearance form used by the Department of Education Division of Misamis Occidental. It contains sections for the employee to provide their purpose of clearance, their work-related accountabilities, money and property accountabilities, and certification that there are no pending administrative cases against the employee. Various department and unit heads must sign the form to certify the employee has been cleared in their respective areas. Instructions are provided on the back for how to fill out and process the form.

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Genieva Dado Angcot
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218 views

Clearance Form: Edwin R. Maribojoc, Edd, Ceso Vi

This document is a clearance form used by the Department of Education Division of Misamis Occidental. It contains sections for the employee to provide their purpose of clearance, their work-related accountabilities, money and property accountabilities, and certification that there are no pending administrative cases against the employee. Various department and unit heads must sign the form to certify the employee has been cleared in their respective areas. Instructions are provided on the back for how to fill out and process the form.

Uploaded by

Genieva Dado Angcot
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
You are on page 1/ 2

Enclosure No. 1 to Division Memorandum No. , s.

2019
CS Form No. 7
Series of2018
Revised 2017 DEPARTMENT OF EDUCATION
DIVISION OF MISAMIS OCCIDENTAL
CLEARANCE FORM
(Instructions at the back)

I PURPOSE

Date of Filing
TO: DepEd, Division of Misamis Occidental
I hereby request clearance from money, property and work-related accountabilities for:
Purpose: £ Transfer £ Resignation £ Other Mode of Separation:
£ Retirement £ Leave Please specify: __________________________
Date of Effectivity: __________________________________________________________

Office of Assignment: ____________________________


______________________________________
Position/SG/Step: ____________________________ Name and Signature of Employee
II CLEARANCE FROM WORK-RELATED ACCOUNTABILITIES
We hereby certify that this employee is cleared / not cleared of work-related accountabilities from this Unit/Office/Dept.

_______________________________ EDWIN R. MARIBOJOC, EdD, CESO VI


Immediate Supervisor Head of Office
III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES
Name of Unit/Office/Department Cleared Not Cleared Name of Clearing Officer/Official Signature
1. Administrative Services

a. Supply and Property Procurement and


Management Services ALBERTO C. PANTO, JR.

b. Human Resource Welfare & Assistance ELMA CEZARIE Y. ROMERO

c. Administrative Officer V JOHNNY M. BELOY

d. Agency-accredited Union/Cooperative TERESITA D. ARANAS


2. Library

VILMA M. INSO
a. Legal Office Library and Library Services
3. Finance and Assets Management

a. Financial Services, Transaction, Processing &


Billing Services ROBERTO L. TORRES, CPA

c. Payroll & Remittance Services DEXTER I. PALAO


4. Professional and Institutional Development

a. Scholarship Services QUEENIE DARRAH S. TAÑAMOR


IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:

a. Internal Affairs Office/Legal Affairs Office ATTY. ALMA M. ADRIAS


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.

______________EDWIN R. MARIBOJOC, EdD, CESO VI__________________


Assistant Schools Division Superintendent
Officer-In-Charge
Office of the Schools Division Superintendent
Employee Copy
Copy for Payroll/Voucher
Copy for HR Unit
Copy for Accounting/Auditing

Page 1 of 2
INSTRUCTIONS:

1. Employees who are retiring, being separated, transferring to other agencies,


leaving the Philippines and going on leave of absence for more than 30 days
shall prepare this form in quadruplicate.

2. This clearance should be duly accomplished before paying the last salary or
any money due the employees. (Specify which type of clearance: maternity
leave, retirement, transfer, etc.)

3. If the employees are cleared from a unit/office/department, the


clearing/authorized official may attach to this clearance the pertinent
document/s that shall prove that the employees are cleared of any obligation
or accountability from their office, if any, and tick the box under the "Cleared"
column before affixing their signatures.

4. If the employees appear to have uncleared accountability/ies from a


unit/office/department, the clearing/authorized official shall attach to this
clearance the pertinent document/s that shall prove that the employees have
remaining obligation or accountability from their office further indicating the
necessary action/s that the employee must satisfy in order to be cleared, and
tick the box under the "Uncleared" column. The clearing/authorized official
must only sign this clearance corresponding to their name once the employee
have complied the necessary requirements and cleared of all the obligation/s
and accountability/ies from their office. They must also tick the box under the
"Cleared" column.

5. The HRMO shall distribute copies of approved clearance as follows: original to


the employee; duplicate to be attached to the payroll or voucher; triplicate to
human resource unit file; and fourth copy to accounting/auditing office.

6. Processing of clearance certificate shall follow the order of number indicated.

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