Republic of the Philippines

Department of Education
Cordillera Administrative Region
Schools Division of Benguet
CORDILLERA REGIONAL SCIENCE HIGH SCHOOL

T E A C H E R ‘ S CL E A R A N C E
CORDILLERA REGIONAL SCIENCE HIGH SCHOOL LA TRINIDAD _____________
School Municipality Date

SALLY L. BANAKEN-ULLALIM CESO V

Schools Division Superintendent
Schools Division of Benguet
Wangal, La Trinidad, Benguet

Thru: MANA C. ESTAKIO

Principal II

Madam:

I have the honor to inform you that I have satisfactorily accounted for all property for which I
am responsible in this school and that all reports required of me were submitted in the dates shown
below. (In case reports are not required, fill blanks accordingly)

1. SF 1 ______________________ completed _______________________, ______

2. SF 2 _______________________completed ______________________, _______
3. SF 4 _______________________completed ______________________, _______
4. SF 5 _______________________completed ______________________, _______
5. DTR (May & June)_________________completed ______________________, _______
6. SF 9 (Report Card) ___________completed ______________________,________
7. SF 10 (Form 137)_____________completed_______________________, _______
8. Complete Settlement of Money and
Property responsibility ____________________completed _____________________,_______
9. All Other Reports ________________________ completed_____________________,_______

I was given regular appointment effective _____________________________,______________.

The inclusive dates of my absences since ___________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
My absences during ____________________________________________________________________
___________________________________________________________ was due to personal reasons.
My absences during ____________________________________________________________________
___________________________________________________________ was due to illness.

Very truly yours,

_____________________________________
Signature Over Printed Name of Teacher
___________________________________________________
Vacation Address of Teacher

Contact Number:___________________
 Republic of the Philippines
Department of Education
Cordillera Administrative Region
Schools Division of Benguet
CORDILLERA REGIONAL SCIENCE HIGH SCHOOL

Date: ________________

SUPPLEMENTARY CLEARANCE FORM

To Whom It May Concern:

This is to Certify that _______________________________ has made a full accounting of all

Cash and property for he/she has been held accountable and/or responsible except as stated below.

O.K . as to: __________________________________________________________________________

__________________________________________________________________________
__________________________________________________________________________

Property:
______________________________________________________________________________

List of articles lost (and paid for books, Amount To whom paid and write
tools/equipment, etc.) Paid complete address

Total Amount Paid

________________________________________ JOHN O. FANGROY

Signature Over Printed Name of Teacher Master Teacher I

MANA C. ESTAKIO
Principal II
 Republic of the Philippines
Department of Education
Cordillera Administrative Region
Schools Division of Benguet
CORDILLERA REGIONAL SCIENCE HIGH SCHOOL

1st Endorsement

Respectfully forwarded to the Division Superintendent of Schools, La Trinidad, Benguet

Province.
The above statements are correct and complete. Clearance is hereby granted. The vacation salary due
this teacher amounts to ______________________________________________ days.

_______________________________
Principal
____________________________________

Date