CS Form No.

7
Series of 2017

Republic of the Philippines

Department of Education
Region IV-A (CALABARZON)
SCHOOLS DIVISION OFFICE OF CAVITE CITY
STA. CRUZ ELEMENTARY SCHOOL
City of Cavite

CLEARANCE FORM
(Instructions at the back)

I PURPOSE

Date of Application
TO: STA. CRUZ ELEMENTARY SCHOOL
I hereby apply for clearance from money, property and work-related accountabilities for:
Purpose: £ Transfer £ Resignation £ Other Mode of Separation:
£ Retirement £ Leave Please specify: __________________________
Effectivity/Inclusive Period:

Office of Assignment: STA. CRUZ ELEMENTARY SCHOOL

LEILA M .BROSAS
Position/SG/Step: PRINCINCIPAL IV/22/4 Name and Signature of Employee
II CLEARANCE FROM WORK-RELATED ACCOUNTABILITIES
We hereby certify that this applicant is cleared of work-related accountabilities from this Unit/Office/Dept.

_______________________________ LEILA M. BROSAS

Immediate Supervisor Principal IV
III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES
Not
Name of Unit/Office/Department Cleared
Cleared
Name of Clearing Officer/Official Signature

1. Administration Sector
Supply and Property Procurement and Management J-ANN G. BENTIR
a.
Services Administrative Officer II

J-ANN G. BENTIR
b. Human Resource Welfare & Assistance Administrative Officer II

MARILOU M. BAZAN
c. Agency-accredited Union/Cooperative Teacher's Club President

2. Library

NONE
a. Legal Office Library
FLORINDA F. ROMERO School
b. Library Services Librarian
3. Finance and Assets Management
DANIELLA MARIA F. DELOS REYES
Teacher's Club Auditor
a. Financial Services
HERMALYN S. ADVINCULA
b. Transaction, Processing & Billing Services School BAC Chairman

HERMALYN S. ADVINCULA
c. Payroll & Remittance Services MOOE Coordinator
4. Professional and Institutional Development
VIOLETA C. CAYANAN
a. Scholarship Services Professional Development Coordinator

IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:

ROSELYN M. SANCHEZ
a. Internal Affairs Office/Legal Affairs Office Guidance Teacher

with pending administrative case

with ongoing investigation (no formal charge yet)

V CERTIFICATION

LEILA M. BROSAS
Principal IV

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