School Clearance

Department of Education
Region VIII
DIVISION OF SOUTHERN LEYTE
DISTRICT OF SAN RICARDO
School Year: 2013-2014
The District Supervisor
Pintuyan, Southern Leyte
(Through Channels)
Sir:
I have the honor to advice that Office that I have completely accounted for and settled all money and
property responsibility for which I was responsible in ESPERANZA NATIONAL HIGH SCHOOL and that all reports
required of me are submitted on the dates shown below:
Reports Required
1. BPS Form 1
2. BPS Form 2
3. CS Form 48 for the last School Month
4. School Form 5 (I-IV)
5. DepEd Form 137-A for students enrolled
6. DepEd Form 138-A (I-IV)-Report Cards
7. Grade Sheets (I-IV)
8. All Money Responsibilities:
Other Collections
9. Form 9
10. Diploma
11. Form 86 (X-ray/Urinalysis)
12. Enhanced Learning Parks
13. Inventory of Books, Equipment and Other School
Properties
14. Safekeeping of Property (Room, Padlock, etc.)
15. Broken Desk and Other School Furniture Repaired
16. Duplicate Keys to Classroom left to OIC/TIC/School Head
17. Liquidation of School Club Funds
18. School 201 File (Updated) c/o JCCanon

Date Submitted
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JACKYLOU SALUDES-SARSALE
Teacher
SOFRONIA S. MERCADO
Secondary School Principal

FLORDELIZA T. COME
School Nurse

School O.K. as to the above responsibility
JOSEFINA S. CONCEPCION
School Property Custodian
TERESITA V. CAMPOS
MARIA CHIREZA C. FIGURA
PTA Treasurer
School Treasurer
------------------------------------------------------------------------------------------------------------------------------------------------1st Endorsement
District of San Ricardo, Esperanza National High School
Respectfully forwarded to the District Supervisor, San Ricardo, Southern Leyte, with the information that
complete clearance is being granted. The best service of the above teacher for the school year 2013-2014 in the
Municipality of San Ricardo, Southern Leyte on ____________________________, 2014.
APPROVED:
ASTERIO A. CLERIGO
District Supervisor