Republic of the Philippines

Department of Education
Region III – Central luzon
Division of Pampanga
MANDILI HIGH SCHOOL
Sapang Bayu, Mandili, Candaba, Pampanga

ICT EQUIPMENT ACCOUNTABILITY FORM

______ Office / Department Use
______ Personal Use
Name: Department: JHS _____ SHS _____

Position: Date:

ICT UNITS
Ite ICT Description Serial Remarks
m Equipment/Model/Brand Number
No.
1. Acer Tablet 10.1 inch/64gb/4gb ram
2. Mouse
3. Keyboard
4. Tablet Charger
5. Tablet Bag

ACKNOWLEDGEMENT
This is to acknowledge that I am accountable for the above items. I understand that I will
pay or replace the same unit in case of loss or damage due to my fault or negligence. In
case of resignation, separation or transfer, I will turnover these items before the issuance of
my clearance. For any additional software protected with license installed that do not
appear in the list above, or do not have any supporting document/s coming from the
School Head or Property Custodian, it is my responsibility to face any charges /liability
coming from the software authority or organization. Also, I will follow the rules and
regulation imposed by the School Head or Property Custodian and I will be liable for any
consequence that may arise for not complying with the rules and regulations.

Conforme: Verify by:

________________________________ GEOFFRY J. SANGALANG

_____________________________
Signature over printed name PROPERTY CUSTODIAN

Approved by:

RUNILO T. SANGUYO
________________________________
PRINCIPAL I