Department of Education  

Region III – Central Luzon

DIVISION OF PAMPANGA  
 
Ayala High School
Rice Village, Ayala, Magalang, Pampanga
Email: ayalahs306938@gmail.com
 

RELIEF OF ACCOUNTABILITY FOR LOST BOOK

__________________________

To the School Librarian:

I, ___________________________________, request relief of accountability of the lost book

titled __________________________ and certify that ______________________________
from Grade ______________________ to whom I issued the book has officially dropped since
_________________________ because ___________________________________________

____________________________________________________________________________.
He/She has not returned the book and I no longer have access to his/her whereabout to
retrieve the said book.

Your approval will be highly appreciated. Thank you.

Respectfully yours,
__________________________________
Teacher/ Adviser

Noted:

ARIEL L. BANAL
School Head