Department of Education Region IX, Zamboanga Peninsula Division of Zamboanga City BUNGUIAO NATIONAL HIGH SCHOOL Bunguiao, Zamboanga

City TEACHERS CLEARANCE School Year 2011-2012 The School Division Superintendent Division of Zamboanga City Zamboanga City Madam: I have the honor to inform you that I have satisfactorily accounted for all the properties for which I was responsible in the school and reports required of me were both submitted on the dates shown below: Date Submitted Date Submitted No. Description No. Description
1 2 3 4 5 6 7 8 9 BPS Form 1,2,3 BPS Form 18-B, 18-C BPS Form 18-A BPS Form 30 BPS Form 112, 113 BPS Form 137-A, 137-B CS Form 48 (DTR) National/City Clearance Ranking List 10 11 12 13 14 15 16 17 18 Report of Drop Out Report of Transferred In Report of Transfer School Fees Collection PAST with IWP Medical Exam/X-ray MPS SALN Others: Inventory

a. b. c. d. e.

Do you have shortage during the year or semester? Please Check YES ( ) NO ( ) To whom did you pay your shortages? ________________________ How much did you pay? _____________ Receipt No. _______ Date _________ Write below the article/s- property/ies you lost. Description Unit Price Total

DANILO F. EUGENIO Secondary School Teacher I

ASPAR A. KASA __________

CORTIZ Y. BARRAMEDA

Property Custodian

Librarian 1st Endorsement

Designated Disbursing Officer

Respectfully forwarded to the Schools Division Superintendent, Division of Zamboanga City the last day of service of this teacher at Bunguiao National High School was March 31, 2012. The above statement is correct and a CONDITIONAL CLEARANCE is hereby granted. JULIETO H. FERNANDEZ Secondary School Principal II Approved: PEDRO MELCHOR M. NATIVIDAD, CSEE Schools Division Superintendent