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Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IV A CALABARZON
DIVISION OF LAGUNA
Santa Cruz
________________
Date
TO WHOM IT MAY CONCERN
THIS IS TO CERTIFY that _____________________________________,
_________________ of __________________________ has been cleared of all money and
property and other accountabilities as of this date.
This certification is issued in connection with her _________________on
____________.

_____________________
Treasurer
Custodian

______________________
District Property

______________________
Head Teacher/Principal
______________________
District Supervisor

As to money accountability
accountability
(Cash Advances, Provident Fund Loan, etc.)

__________________
Division Accountant II

As to money

_____________________________
Administrative Officer

III
______________________
Administrative Aide IV
As to pending administrative cases or criminal charges
_____________________
Administrative Officer III
Approved:
____________________________
Schools Division Superintendent

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