Republic of the Philippines

Department of Education
REGION I
SCHOOLS DIVISION SUPERINTENDENT
BRGY. TALANG San Carlos City, Pangasinan

DOCUMENT CREATION, CHANGE AND REMOVAL REQUEST (DCCRR)

Control Number: ___________

Functional Division/Unit or Section:

Request for New Document Revision Removal

Document Title : _____________________ Revision No.:00

Document Code: _____________________ Page(s): 1

Reason for Change (If new document please write N/A)

_________________
Prepared by: (Superseded Document/s if any)

__________________________ ______________ Document Code: ____________________________________

Document Controller/Alternate Date __________________________________________________
__________________________________________________
__________________________________________________
Document Review and Approval Section: __________________________________________________
Document Title: _____________________________________
__________________________________________________
For new document (Reviewed and Approved) __________________________________________________
__________________________________________________
For modified document (Reviewed for Modification) __________________________________________________
__________________________________________________
For removed document (Reviewed for Removal) __________________________________________________
Effectivity Date: _____________________________________
__________________________________________________
Agreed on the proposed/modified/removed document Approved by:

_______________________ ______________ _______________________ _______________

Unit/Section Head Date Head of Functional Division Date

Effectivity Date: _______________

Document Validation Section:

Validated by:

_____________ __________________
Overall Document Controller Date

Finalized by:
____________________ __________________
Quality Management Represent Date

Address: Brgy. Talang, San Carlos City, Pangasinan Document Code: SCC-C3-QF-001
Telephone No.: Revision: 00
Email Address: 102250@deped.gov.ph Effectivity Date: 01-06-2020