Republic of the Philippines

Department of Education
Region XII
Division of Sultan Kudarat
_____________(name of school)__________________
Municipality, Sultan Kudarat
______________________
Date
THE SCHOOLS DIVISION SUPERINTENDENT
Division of Sultan Kudarat
Kenram, Isulan, Sultan Kudarat

Sir:
I have the honor to report that I have satisfactorily accounted for all property, which I am responsible in this school and
all the reports required of me have submitted on the dates shown below:

School Form 1 ______________________ C.S. Form 48 _______________________

School Form 2 ______________________
School Form 3 ______________________
School Form 5 ______________________
BPS Form 138-A ____________________
BPS Form 137-A ____________________
BPS Form 48 _______________________
Property Inventory ___________________
Amount Paid Property Short # __________
Special School Funds _________________
Other Special Reports _________________

Resignation ___________ if so, has application been submitted? ____________________.

Leave _______________ if so, is CS Form 6 attached? ________________. School plant and equipment left in the charge
of the __________________________.

My last day of authorized service in the school is ________________ until _______________. My mailing
Address will be __________________, _______________________, _____________________.
St./Barangay Municipality Province

Very truly yours,

________________________
Employee

________________________ ___________________________ __________________________

(Faculty Club Pres.) (Guidance Counselor Designate) (Property Custodian)

________________________ ___________________________ __________________________

Association Treasurer ADAS III (Bookkeeper) ADAS II

__________________________ ____________________________ ____________________________

ADAS II (Disbursing Officer)

Recommending Approval:

LOUENEL A. ELISES
Administrative Officer V
__________________________________________________________________________________________________
1st Endorsement
__________________________________________

______________________
Date

Respectfully forwarded to the Schools Division Superintendent, Division of Sultan Kudarat with information that the
above statements are correct and the COMPLETION/CONDITIONAL is hereby accepted/granted.

LEONARDO M. BALALA
Schools Division Superintendent