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Republic of the Philippines Document Code: SDO-SCC-QF-

Department of Education OSDS-SUP-012


Region I Revision: 00
SCHOOLS DIVISION OF SAN CARLOS CITY
Effectivity date: 07-01-18
San Carlos City
Name of Office:
PROPERTY ACKNOWLEDGMENT RECEIPT
OSDS – SUPPLY OFFICE
Reference No.: ______________ Date: ________________

Appendix 71

Entity Name : ______________________________________


Fund Cluster: ______________________________________ PAR No.: _________________

Property Date
Quantity Unit Description Amount
Number Acquired
3 green cabinet Dec-19

Received by: Issued by:

NERISSA C. LAYOG VIRGINIA M. PRIMAVERA


Signature over Printed Name of Supply and/or Property
Signature over Printed Name of End User
Custodian
TEACHER III _______________________________
Position/Office Position/Office
19-Feb-20 _________________________
Date Date
Republic of the Philippines Document Code: SDO-SCC-QF-
Department of Education OSDS-SUP-011
Region I Revision: 00
SCHOOLS DIVISION OF SAN CARLOS CITY
Effectivity date: 07-01-18
San Carlos City
Name of Office:
INVENTORY CUSTODIAN SLIP
OSDS – SUPPLY OFFICE
Reference No.: ________________ Date: 08-19-2019

Entity Name: Speaker Eugenio Perez National Agricultural School


Fund Cluster : 01 ICS No : _______________________

Amount
Inventory Item Estimated Useful
Quantity Unit Unit Total Description
No. Life
Cost Cost
6 Coil spring
15 graduated cylinder
10 surgical gloves
2 cork borer set of 6
6 dissecting pan
6 dissecting set
1 laser pointer
1 calculator
1 graphing board

Received from: Received by:

VIRGINIA M. PRIMAVERA NERISSA C. LAYOG


Signature Over Printed Name Signature Over Printed Name
Administrative Officer I - Supply Officer TEACHER III
Position/Office Position/Office
FEBRUARY 19, 2020
Date Date
Republic of the Philippines Document Code: SDO-SCC-QF-
Department of Education OSDS-SUP-012
Region I Revision: 00
SCHOOLS DIVISION OF SAN CARLOS CITY
Effectivity date: 07-01-18
San Carlos City
Name of Office:
PROPERTY ACKNOWLEDGMENT RECEIPT
OSDS – SUPPLY OFFICE
Reference No.: ______________ Date: ________________

Appendix 71

Entity Name : ______________________________________


Fund Cluster: ______________________________________ PAR No.: _________________

Property Date
Quantity Unit Description Amount
Number Acquired
3 green cabinet Dec-19

Received by: Issued by:

IMELDA M. HIPOLITO VIRGINIA M. PRIMAVERA


Signature over Printed Name of Supply and/or Property
Signature over Printed Name of End User
Custodian
TEACHER III _______________________________
Position/Office Position/Office
19-Feb-20 _________________________
Date Date
Republic of the Philippines Document Code: SDO-SCC-QF-
Department of Education OSDS-SUP-011
Region I Revision: 00
SCHOOLS DIVISION OF SAN CARLOS CITY
Effectivity date: 07-01-18
San Carlos City
Name of Office:
INVENTORY CUSTODIAN SLIP
OSDS – SUPPLY OFFICE
Reference No.: ________________ Date: 08-19-2019

Entity Name: Speaker Eugenio Perez National Agricultural School


Fund Cluster : 01 ICS No : _______________________

Amount
Inventory Item Estimated Useful
Quantity Unit Unit Total Description
No. Life
Cost Cost
6 Coil spring
15 graduated cylinder
10 surgical gloves
6 dissecting pan
6 dissecting set
1 laser pointer
1 calculator

Received from: Received by:

VIRGINIA M. PRIMAVERA IMELDA M. HIPOLITO


Signature Over Printed Name Signature Over Printed Name
Administrative Officer I - Supply Officer TEACHER III
Position/Office Position/Office
FEBRUARY 19, 2020
Date Date
Republic of the Philippines Document Code: SDO-SCC-QF-
Department of Education OSDS-SUP-012
Region I Revision: 00
SCHOOLS DIVISION OF SAN CARLOS CITY
Effectivity date: 07-01-18
San Carlos City
Name of Office:
PROPERTY ACKNOWLEDGMENT RECEIPT
OSDS – SUPPLY OFFICE
Reference No.: ______________ Date: ________________

Appendix 71

Entity Name : ______________________________________


Fund Cluster: ______________________________________ PAR No.: _________________

Property Date
Quantity Unit Description Amount
Number Acquired
2 green cabinet Dec-19

Received by: Issued by:

NERISSA C. LAYOG RIZZALY D. SIAPNO


Signature over Printed Name of Supply and/or Property
Signature over Printed Name of End User
Custodian
TEACHER III _______________________________
Position/Office Position/Office
19-Feb-20 _________________________
Date Date
Republic of the Philippines Document Code: SDO-SCC-QF-
Department of Education OSDS-SUP-011
Region I Revision: 00
SCHOOLS DIVISION OF SAN CARLOS CITY
Effectivity date: 07-01-18
San Carlos City
Name of Office:
INVENTORY CUSTODIAN SLIP
OSDS – SUPPLY OFFICE
Reference No.: ________________ Date: 08-19-2019

Entity Name: Speaker Eugenio Perez National Agricultural School


Fund Cluster : 01 ICS No : _______________________

Amount
Inventory Item Estimated Useful
Quantity Unit Unit Total Description
No. Life
Cost Cost
6 Coil spring
15 graduated cylinder
10 surgical gloves
6 dissecting pan
6 dissecting set
1 laser pointer
1 calculator

Received from: Received by:

VIRGINIA M. PRIMAVERA RIZZALY D. SIAPNO


Signature Over Printed Name Signature Over Printed Name
Administrative Officer I - Supply Officer TEACHER III
Position/Office Position/Office
FEBRUARY 19, 2020
Date Date
Republic of the Philippines Document Code: SDO-SCC-QF-
Department of Education OSDS-SUP-012
Region I Revision: 00
SCHOOLS DIVISION OF SAN CARLOS CITY
Effectivity date: 07-01-18
San Carlos City
Name of Office:
PROPERTY ACKNOWLEDGMENT RECEIPT
OSDS – SUPPLY OFFICE
Reference No.: ______________ Date: ________________

Appendix 71

Entity Name : ______________________________________


Fund Cluster: ______________________________________ PAR No.: _________________

Property Date
Quantity Unit Description Amount
Number Acquired
3 green cabinet Dec-19

Received by: Issued by:

AILEEN TAMAYO VIRGINIA M. PRIMAVERA


Signature over Printed Name of Supply and/or Property
Signature over Printed Name of End User
Custodian
TEACHER I _______________________________
Position/Office Position/Office
19-Feb-20 _________________________
Date Date
Republic of the Philippines Document Code: SDO-SCC-QF-
Department of Education OSDS-SUP-011
Region I Revision: 00
SCHOOLS DIVISION OF SAN CARLOS CITY
Effectivity date: 07-01-18
San Carlos City
Name of Office:
INVENTORY CUSTODIAN SLIP
OSDS – SUPPLY OFFICE
Reference No.: ________________ Date: 08-19-2019

Entity Name: Speaker Eugenio Perez National Agricultural School


Fund Cluster : 01 ICS No : _______________________

Amount
Inventory Item Estimated Useful
Quantity Unit Unit Total Description
No. Life
Cost Cost
6 Coil spring
15 graduated cylinder
10 surgical gloves
6 dissecting pan
6 dissecting set
1 laser pointer
1 calculator

Received from: Received by:

VIRGINIA M. PRIMAVERA AILEEN TAMAYO


Signature Over Printed Name Signature Over Printed Name
Administrative Officer I - Supply Officer TEACHER I
Position/Office Position/Office
FEBRUARY 19, 2020
Date Date
Republic of the Philippines Document Code: SDO-SCC-QF-
Department of Education OSDS-SUP-012
Region I Revision: 00
SCHOOLS DIVISION OF SAN CARLOS CITY
Effectivity date: 07-01-18
San Carlos City
Name of Office:
PROPERTY ACKNOWLEDGMENT RECEIPT
OSDS – SUPPLY OFFICE
Reference No.: ______________ Date: ________________

Appendix 71

Entity Name : ______________________________________


Fund Cluster: ______________________________________ PAR No.: _________________

Property Date
Quantity Unit Description Amount
Number Acquired
2 green cabinet Dec-19

Received by: Issued by:

VANESSA SHEILA S. BULATAO VIRGINIA M. PRIMAVERA


Signature over Printed Name of Supply and/or Property
Signature over Printed Name of End User
Custodian
TEACHER I _______________________________
Position/Office Position/Office
19-Feb-20 _________________________
Date Date
Republic of the Philippines Document Code: SDO-SCC-QF-
Department of Education OSDS-SUP-011
Region I Revision: 00
SCHOOLS DIVISION OF SAN CARLOS CITY
Effectivity date: 07-01-18
San Carlos City
Name of Office:
INVENTORY CUSTODIAN SLIP
OSDS – SUPPLY OFFICE
Reference No.: ________________ Date: 08-19-2019

Entity Name: Speaker Eugenio Perez National Agricultural School


Fund Cluster : 01 ICS No : _______________________

Amount
Inventory Item Estimated Useful
Quantity Unit Unit Total Description
No. Life
Cost Cost
6 Coil spring
15 graduated cylinder
10 surgical gloves
6 dissecting pan
6 dissecting set
1 laser pointer
1 calculator

Received from: Received by:

VIRGINIA M. PRIMAVERA VANESSA SHEILA S. BULATAO


Signature Over Printed Name Signature Over Printed Name
Administrative Officer I - Supply Officer TEACHER III
Position/Office Position/Office
FEBRUARY 19, 2020
Date Date

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