School Form 3 (SF3) Books Issued and Returned

(This replaces Form 1 & Inventory of Textbooks)

School ID 128001 School Year 2021 - 2022

School Name Canitoan Elementary School Grade Level Grade 6 Section SATURN
Subject Area & Subject Area & Title / Subject Area & Title / Subject Area & Title / Subject Area & Title / Subject Area & Title / Subject Area & Title / Subject Area & Title / Subject Area & Title / Subject Area & Title /
Title/Module Reference Module / Reference / Module / Reference / Module / Reference / Module / Reference / Module / Reference / Module / Reference / Module / Reference / Module / Reference / Module / Reference /
NAME Code Code Code Code Code Code Code Code Code Code
No REMARKS/ACTION TAKEN
(Last Name, First Name, Middle (Please refer to the legend on last
. page)
Name) Date Date Date Date Date Date Date Date Date Date
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

1 BAHIAN,JENISES, CUBAY

2 BUTON, ROQUE JR. R

3 CABASA,JOHN MICHAEL, NERI

4 DALAYGON, GANIEL

EDROTE,ROBIN ROSS, JR
5
GOMEZ

6 EDUSMA,JAIRUS JAY, DACULA

7 ENTELISO, BRYLE ANGELO V.

GANORA,CHRISTOPHER,
8
CANOMON
GAUD,KING PHILLIP,
9
SALOCANA
JACOB,CHRIS PAUL,
10
TABOCLAON
LOSENTES, JED ANGELO
11
JOHANN G.
MADREDANO,DANIEL
12
ANGELO, -

13 MAINIT,JAIRO, JABONILLO

PACAMO,JEOFF RANDEL,
14
LABAJO
PAGTALUNAN,NIEL,
15
HENGANIA

16 PAIGNA, MICHAEL E.

17 REBOSURA,PAUL, -

18 RESUELO, CRISRICK M

SIAROT,BRYAN JAMES,
19
TALUNDATA
VILLAVETO,ZECH JAYDEN,
20
FABORADA
 <=== TOTAL FOR MALE |
20
TOTAL COPIES ===>
ABRAGAN,GLECEL MAE,
1
PONDOC
ABUJAN,HASHLEY MAE,
2
ASILO
ALGURA,ANGEL MAE,
3
MANAYON

4 BALGOMA, CRISPOL Y.

5 BANDIOLA, MICHELLE D.

BENTONG,FRANCEY ISABELLI,
6
MALAZARTE
BITAMOR,JANINE FAITH,
7
LACUNA
CABAÑAS,TRISHA NICOLE,
8
AMPER
CUÑADA,ALLIANA JOYCE,
9
ALFORQUE
CUNANAN,MARIANNE JOY,
10
HINOBIAGON
DAAYATA,APRIL ROSE,
11
PANAL

12 DELA PEÑA,MARIAN, REYES

13 DULAPO,KHATE LYN, EDUAVE

14 MAASIN,GWYNETH, MANCIA

15 OSABEL,RAVEN SPRY, -

PASAYON,FHIRLGRACE KATE,
16
CABATINGAN

17 SACABIN,JANINE, DIANGO

18 SUSON,QUENNIE, NOYNAY

19 TIMAY,BRIANNA SOPHIA, -

VALDON,ELIJAH GREG,
20
BENEMERITO
<=== TOTAL FOR FEMALE |
29
TOTAL COPIES ===>
<=== TOTAL LEARNERS |
55
TOTAL COPIES ===>
Prepared By:
GUIDELINES: In case of lost/unreturned books, please provide information with the following code:

1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form.
3. The Total Number of Copies issued at BoSY shall be reflected in the form.
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form.
5. All textbooks being used must be included. Additional copies of this form may be used if
needed.
A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by
parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission
GINA T. DAZO
to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code NEG). References: DO#23, (Signature of Adviser over Printed Name)
s.2001, DO#25, s.2003, DO#14, 2.2012.

Generated thru LIS

Date of BoSY:___/___/_____ Date of EoSY: ___/___/_____