Republic of the Philippines

Province of Eastern Samar

Region VIII
Division of Eastern Samar
DAPDAP NATIONAL TECHNICAL VOCATIONAL HIGH SCHOOL
Dolores

_____________
Date

The Regional Director
DepEd Regional Office No. VIII
Candahog, Palo Leyte


Maam:

I have the honor to advice you that have satisfactory accounted for all money and property for which
I am responsible in this school and all reports required of me on dates below.

Enter dates reports or write Not Required on space provided
1. DepEd School Form 1 __________________________
2. DepEd School form 2 _________________________
3. CS Form 48 __________________________________
4. CS Form 35 or 39 _____________________________
5. BPS Form 122 ________________________________
6. BPS Form 133 ________________________________
7. DepEd Form 137-Accomplished & Filed ________
8. DepEd Form 138-A ___________________________
9. BPS Form 131 Balance ________________________
10.Municipal Money and Property Clearance
________________________
11. Assets and Liabilities Clearance ___________________
12. Income Tax Clearance __________________________
13. Has special permit to possess as arms been settled
___________________________
14. Has account with the teachers organization has
been settled____________________
15. Resignation ____________________________________
16. BPS Form 24 should be submitted for American
Teachers ______________________________________
17. Live Abroad __________________________________
18. live in the Philippines __________________________
19. Transfer ______________________________________
20. BPS Form 133, in case of transfer should not be
accomplished upon rendering first day of service in
new station _________________________________
Absences During the Past Three Months
Until further notice, mailing address will be

This clearance is valid only

Very truly yours,
Recommending approval:



TEA Treasurer Administrative Officer Designate School Librarian




Supply Officer DNTVHS MPC Treasurer FPTA Treasurer

Approved:

LYNN T. ABELLA
Secondary School Principal I