Department of Education
Department of Education
Region III
Division of City Schools
San Fernando East District
SAN JOSE PANLUMACAN ELEMENTARY SCHOOL
City of San Fernando (P)
Tel. No. (045) 961-1456
TEACHERS CLEARANCE
____________________
(Date)
ESPERANZA L. LAYA,Ph.,D.CESO V SCHOOLS DIVISION
SUPERINTENDENT
City of San Fernando (P)
S i r / M a d a m :
I have the honor to inform you that I have submitted the
following requirements to wit:
FINANCIAL REPORTDepEd Form 1_________________ a. PTA:
_______________________________DepEd Form 2 ________________ b.
School Operating Budget _______________DepEd Form 3
________________ c. School Organ ________________________DepEd Form
137 ______________ d. Red Cross ___________________________DepEd
Form 138-E ____________ e. BSP / GSP Registration
________________DepEd Form 18-E-1 ___________ f. Homeroom
__________________________DepEd Form 18-E-2 ___________ g. P.E.
________________________________DepEd Form 20 _______________ h.
BSP ________________________________DepEd Form 8-C ______________
i. GSP ________________________________DepEd Form 48 ______________
j. Anti TB _____________________________Report of Pupils k.
Graduation Fees ______________________ Accomplishment ___________
l. Membership Fees______________________Inventory of :
a. Garden Tools _____________ Books,Manuals Borrowed:
________________ b. Shop Tools _______________ Books Losses Report:
___________________ c. H.E. Equipment ___________ a. Amount Paid:
_____________________ d. Duplicate Keys ___________ b. To whom:
________________________
In view of this, clearance is hereby requested
Vacation Address: Very truly
yours,______________________________
__________________________________________________________________
Teacher______________________________JULIET S. MIRANDA AIREEN P.
GUTIERREZ CECIL P. GUINTO School Treasurer School Auditor Property
Custodian
Approved:LANI P. DELUMENPrincipal IIJsm 04022014
