FOR UNIVERSITY CLEARANCE APPLICATION ONLY

UP Form 241 (Revised Mar 2012)

(To be filled up by OSCC personnel)

PENDING ACCOUNT WITH _________________________

OFFICE OF THE UNIVERSITY REGISTRAR

UNIVERSITY OF THE PHILIPPINES - DILIMAN
One-Stop Student Clearance Center (OSCC)

DATE RECEIVED _________ BY _______

IMPORTANT: 1. PLEASE PROVIDE ACCURATE AND COMPLETE DATA TO AVOID DELAY

IN PROCESSING
2. KEEP YOUR CLEARANCE CARD WHICH YOU WILL PRESENT EACH
TIME YOU TRANSACT BUSINESS REQUIRING CLEARANCE
(e.g. APPLICATION FOR TRANSCRIPT OF RECORDS, DIPLOMA,
HONORABLE DISMISSAL and CERTIFICATE OF GRADUATION).

STUDENT NO.

1 9 9 8 - 0 8 0 6 7

TRANSCRIPT FUND B
CODE # 9774711 - Records Section
CERTIFICATION:
CLEARANCE - 30.00
O.R. No. : ______________________
AMT. PAID : ____________________
DATE : ________________________

Transcript of Records, Diploma

PURPOSE: Official
____________________________________________________
Certificate of Graduation
____________________________________________________
____________________________________________________

SEBASTIAN, BOBBY JOHNSON, OLAVIDES

NAME _____________________________________________________________________
SIGNATURE ________________
First Semester AY 2003-2004
VSB
FIRST ENROLLMENT IN U.P. ______________________________________________________________________________
SEMESTER

ACADEMIC YEAR

COLLEGE

Second Semester AY 2014-2015

Law
LAST ENROLLMENT IN U.P. ______________________________________________________________________________
SEMESTER

ACADEMIC YEAR

YEAR GRADUATED __________________________________

COLLEGE

DEGREE ___________________________________

24 7th Ave., GRACE PARK WEST, KALOOKAN CITY(SOUTH)

PRESENT ADDRESS __________________________________________________________

First Time to Apply

Yes

No

CONTACT NO. (Landline/Mobile phone) ______________________________

E-MAIL: ____________________________________
09179007399 / 9450126
bjosebastian2@gmail.com

PROCEED TO THE FOLLOWING OFFICES TO SETTLE ACADEMIC DELINQUENCIES AND/OR ACCOUNTABILITIES

You do not have any accountabilities to settle.
OFFICE OF THE UNIVERSITY REGISTRAR
Graduation Fee _________________ OR# _______________ Date ________________
UNDERASSESSMENT
Nature

Semester

Amount

OR#

Date

ENTRANCE CREDENTIALS SUBMITTED

Official Transcript of Records ____________________
High School Card______________________________
F 137 _______________________________________
____________________________________________
GRADUATED IN U.P.

YES

NO

DEGREE & DATE ____________________________

CLEARED BY
ROWENA T. ESCLANDA
OFFICER-IN-CHARGE
ADMISSION AND REGISTRATION SECTION

DATE _________________
AS OF _________________
2nd Sem 14-15