CS Form No.
7
Series of 2017
Series of 2017 Republic of the Philippines
Department of Education
SCHOOLS DIVISION OF NUEVA ECIJA
-o0o
DIVISION CLEARANCE FORM*
(Instructions at the back)
I PURPOSE For transfer of school assignment
May 29, 2019
(Date of Application)
TO: The Schools Division Superintendent
DepEd, Schools Division of Nueva
Santa Rosa, Nueva Ecija
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: General Luna Integrated School
MA. EDALIZ B. DUNGCA
Position/SG/Step: ADAS II, SG 8 - Step 1 (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.
RIZALDY T. CARITATIVO
School Head
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
a. Management Services ALBERTO TECSON
2. Library
b. Library Services JENNIFER BANAYAT
3. Finance and Assets Management
a. Financial Services (Accountant) MARAH M. PACSON
c. Payroll & Remittance Services (Cashier II) GLACIE B. DE LEON
IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:
a. Internal Affairs Office/Legal Affairs Office
"
x with pending administrative case
with ongoing investigation (no formal charge yet)
V CERTIFICATION
RONALDO A. POZON, Ph.D. CESO V
Schools Division Superintendent
*submit in 4 Copies Page 1 of 2
rra2017
CS Form No. 7
Series of 2017
Series of 2017 Republic of the Philippines
Department of Education
SCHOOLS DIVISION OF NUEVA ECIJA
-o0o
DIVISION CLEARANCE FORM*
(Instructions at the back)
I PURPOSE For transfer of school assignment
May 29
(Date of A
TO: The Schools Division Superintendent
DepEd, Schools Division of Nueva
Santa Rosa, Nueva Ecija
I hereby apply for clearance from money, property and work-related accoun
Purpose: £ Transfer £ Resignation £ Other Mode of Separation:
£ Retirement £ Leave Please specify: _____________
Effectivity/Inclusive Period: _____________________________________________
Office of Assignment: General Luna Integrated School
MA. EDALIZ B.
Position/SG/Step: ADAS II, SG 8 - Step 1 (Name and Signature
II CLEARANCE FROM WORK-RELATED ACCOUNTABILITIES
We hereby certify that this applicant is cleared of work-related accountabilities from this
RIZALDY T. CAR
School Head
III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES
Not
Name of Unit/Office/Department Cleared
Cleared Name of Clearing Officer/O
1. Administration Sector
Supply and Property Procurement and
a. Management Services ALBERTO TECSON
2. Library
b. Library Services JENNIFER BANAYAT
3. Finance and Assets Management
a. Financial Services (Accountant) MARAH M. PACSON
c. Payroll & Remittance Services (Cashier II) GLACIE B. DE LEON
IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:
a. Internal Affairs Office/Legal Affairs Office MARILOU R. BUENAVENTU
x" with pending administrative case
with ongoing investigation (no formal charge yet)
V CERTIFICATION
RONALDO A. POZON, Ph.D. CESO V
Schools Division Superintendent
*submit in 4 Copies
rra2017
Department of Education
OLS DIVISION OF NUEVA ECIJA
-o0o
ON CLEARANCE FORM*
(Instructions at the back)
May 29, 2019
(Date of Application)
or clearance from money, property and work-related accountabilities for:
£ Other Mode of Separation:
Please specify: __________________________
od: __________________________________________________________
MA. EDALIZ B. DUNGCA
(Name and Signature of Employee)
pplicant is cleared of work-related accountabilities from this Unit/Office/Dept.
RIZALDY T. CARITATIVO
School Head
Name of Clearing Officer/Official Signature
ALBERTO TECSON
JENNIFER BANAYAT
MARAH M. PACSON
GLACIE B. DE LEON
MARILOU R. BUENAVENTURA
ALDO A. POZON, Ph.D. CESO V
Schools Division Superintendent
Page 1 of 2
INSTRUCTIONS:
1. Employees who are retiring, being separated, transferring to other agencies,
leaving the Philippines and going on maternity leave of absence shall prepare
this form in quadruplicate.
2. This clearance should be duly accomplished before paying the last salary or
any money due the employees. (Specify which type of clearance: maternity
leave, retirement, transfer, etc.)
3. If the employees are cleared from a unit/office/department, the
clearing/authorized official may attach to this clearance the pertinent
document/s that shall prove that the employees are cleared of any obligation
or accountability from their office, if any, and tick the box under the "Cleared"
column before affixing their signatures.
4. If the employees appear to have uncleared accountability/ies from a
unit/office/department, the clearing/authorized official shall attach to this
clearance the pertinent document/s that shall prove that the employees have
remaining obligation or accountability from their office further indicating the
necessary action/s that the employee must satisfy in order to be cleared, and
tick the box under the "Uncleared" column. The clearing/authorized official
must only sign this clearance corresponding to their name once the employee
have complied the necessary requirements and cleared of all the obligation/s
and accountability/ies from their office. They must also tick the box under the
"Cleared" column.
5. The HRMO shall distribute copies of approved clearance as follows: original to
the employee; duplicate to be attached to the payroll or voucher; triplicate to
human resource unit file; and fourth copy to accounting/auditing office.
6. Processing of clearance certificate shall follow the order of number indicated.
Page 2 of 2
Republic of the Philippines
Department of Education
DIVISION OF NUEVA ECIJA
GENERAL LUNA INTEGRATED HIGH SCHOOL
Bulo, General Luna, Carranglan, Nueva Ecija
-o0o-
SCHOOL CLEARANCE*
I PURPOSE For transfer of school assignment
May 23, 2019
(Date of Application)
TO WHOM IT MAY CONCERN:
I hereby CERTIFY that Mr./Mrs./Miss MA. EDALIZ B. DUNGCA a permanent
ADAS II (Senior HS) of General Luna Integrated High School
(Position) (School)
with Unique Item Number OSEC-DECSB- ADAS2-150437-2016 PSIPOP FY 2019
Page No. is cleared from MONEY, PROPERTY and WORK-RELATED ACCOUNTABILITIES for:
Purpose: £ Transfer £ Resignation £ Other Mode of Separation:
£ Retirement £ Leave Please specify:
Effectivity/Inclusive Period:
MA. EDALIZ B. DUNGCA
(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.
RIZALDY T. CARITATIVO
School Head
III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES
Not
Name of Unit/Office/Department Cleared
Cleared Name of Clearing Officer/Official Signature
1. Administration Sector
a. Supply and Property Procurement and RUFINO O. MATEO
Management Services
2. Library
b. Library Services GEMMALYN L. PINEDA
3. Finance and Assets Management
a. Financial Services (School Treasurer) ESPERANZA B. VILLA
b. Payroll & Remittance Services (Cashier II)
IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:
Internal Affairs Office/Legal Affairs Office MARILOU R. BUENAVENTURA
a.
with pending administrative case
with ongoing investigation (no formal charge yet)
V CERTIFICATION
RONALDO A. POZON, Ph.D. CESO V
Schools Division Superintendent
