Division Clearance No.

Republika ng Pilipinas
KAGAWARAN NG EDUKASYON
Rehiyon XII
SANGAY NG MGA PAARALANG LUNGSOD
Lungsod ng Heneral Santos

DIVISION CLEARANCE
(Annual Clearance for School Heads)

NAME OF SCHOOL HEAD :

POSITION :
SCHOOL/DISTRICT :

CERTIFIED BY THE AUTHORIZED OFFICIALS:

1. As to Personnel Matters: 2. As to Property Matters: 3. As to Cash Advances, Account

___ SALM Annual Inventory Report Receivable & Traveling Expenses
___ DTR Invoice Receipt for Property Liquidation of:
___ Updated SCS Form 212 (For SHs who transferred _____ Downloaded MOOE
___ IPCRF/RPMS station within the SY) _____ School Feeding Program
___ Teachers Year-end Clearances _____ Travel – Division Fund

LINAMEN C. CATAS DENNIS BABAS TOMAS J. PETALLANA, JR.

HRMO Property Custodian ACCOUNTANT

4. As to Overpayment and Other 5. As to Planning Reports: 6. As to Health Requirements and

Cash Accounts: _____SF4 _____ SF6 School Based Feeding Program
______ Book Losses _____SF5 _____ SF7 reports:
______ Unsigned Payroll/DVs _____LIS/Ebeis ENF SY status

IRENE R. PALER ARMIDA O. SENDICO ANNA RIZZA C. NAPILA

Cashier Planning Officer Head Nurse

6. As to Adopt-A-School Program 7. As to Instructional Supervisory 8. As to Enhanced SIP/School

Reports: Reports; PHIL-IRI/Reading Accomplishment Report
Reports; DECCD/SREA Reports

HERVEN A. ALLADO JULIET F. LASTIMOSA VICTORINO FUENTES, JR.

Senior Education Program Specialist Chief Education Supervisor, CID Chief Education Supervisor, SGOD

9. As to District Office concerns:

RECOMMENDING APPROVAL:

__________________________
MARIO M. BERMUDEZ, CESE
PSDS/PIC
Assistant Schools Division Superintendent

APPROVED:

GILDO G. MOSQUEDA, CEO VI

Schools Division Superintendent

Date:__________________

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IAO V Mayet