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Clearance Form: CS Form No. 7 Series of 2017

This document is a clearance form for an employee transferring or resigning from their position. It requires signatures from the employee's head teacher and district supervisor to confirm they have been cleared of all work-related accountabilities. It also requires signatures from officials in various departments, such as finance, human resources and the legal office, to confirm the employee has no outstanding financial obligations or pending legal cases. Once fully signed, the superintendent will certify that the employee has been cleared from their position. The form provides a standardized process for employees to receive clearance when leaving their role.

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117 views

Clearance Form: CS Form No. 7 Series of 2017

This document is a clearance form for an employee transferring or resigning from their position. It requires signatures from the employee's head teacher and district supervisor to confirm they have been cleared of all work-related accountabilities. It also requires signatures from officials in various departments, such as finance, human resources and the legal office, to confirm the employee has no outstanding financial obligations or pending legal cases. Once fully signed, the superintendent will certify that the employee has been cleared from their position. The form provides a standardized process for employees to receive clearance when leaving their role.

Uploaded by

monica sarmiento
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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CS Form No.

7
Series of 2017 Department of Education
SCHOOLS DIVISION OF BULACAN

CLEARANCE FORM
(Instructions at the back)

I PURPOSE

Date of Application
TO: DepEd Pandi South District Office
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: ANNA MARIE C. ROXAS

Position/SG/Step: 11/3 TEACHER I

II CLEARANCE FROM WORK-RELATED ACCOUNTABILITIES


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

ROSELLE L. DE JESUS ESPERANZA F. PEREZ, EdD


Head Teacher I District Supervisor
III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES
Not
Name of Unit/Office/Department Cleared Cleared Name of Clearing Officer/Official Signature
1. Administration Sector
Supply and Property Procurement and DAISY P. ANTONIO
a.
Management Services
/ Administrative Officer II
DAISY P. ANTONIO
b. Human Resource Welfare & Assistance /
Administrative Officer II

c. Agency-accredited Union/Cooperative NONE

2. Library
AURA A. ESPINAS
a. Legal Office Library /
Administrative Officer II
AURA A. ESPINAS
b. Library Services /
Administrative Officer II
3. Finance and Assets Management
MARIA CRISTINA M. DALISAY
a. Financial Services /
District Treasurer
REYNALDO R. SANTOS
b. Transaction, Processing & Billing Services /
Administrative Assistant III
REYNALDO R. SANTOS
c. Payroll & Remittance Services /
Administrative Assistant III
4. Professional and Institutional Development

a. Scholarship Services N/A

IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:

a. Internal Affairs Office/Legal Affairs Office ATTY. ELMER D. LOPEZ


with pending administrative case
with ongoing investigation (no formal charge yet)

V CERTIFICATION

NORMA P. ESTEBAN, EdD, CESO V


Schools Division Superintendent
Schools Division of Bulacan

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