This 2-page document is a clearance form from the Department of Education for Jean C. Caluyong, a principal at Esperanza Elementary School. [1] It details the purpose of clearance as a transfer to a new school. [2] Supervisors from Esperanza Elementary School and the Schools Division Office certify that Ms. Caluyong is cleared of all work-related responsibilities. [3] Officials from various offices, including Administration, Library Services, and Finance, certify that Ms. Caluyong has no outstanding monetary or property obligations. [4] The agency head signs to certify there are no pending administrative cases against Ms. Caluyong.
This 2-page document is a clearance form from the Department of Education for Jean C. Caluyong, a principal at Esperanza Elementary School. [1] It details the purpose of clearance as a transfer to a new school. [2] Supervisors from Esperanza Elementary School and the Schools Division Office certify that Ms. Caluyong is cleared of all work-related responsibilities. [3] Officials from various offices, including Administration, Library Services, and Finance, certify that Ms. Caluyong has no outstanding monetary or property obligations. [4] The agency head signs to certify there are no pending administrative cases against Ms. Caluyong.
This 2-page document is a clearance form from the Department of Education for Jean C. Caluyong, a principal at Esperanza Elementary School. [1] It details the purpose of clearance as a transfer to a new school. [2] Supervisors from Esperanza Elementary School and the Schools Division Office certify that Ms. Caluyong is cleared of all work-related responsibilities. [3] Officials from various offices, including Administration, Library Services, and Finance, certify that Ms. Caluyong has no outstanding monetary or property obligations. [4] The agency head signs to certify there are no pending administrative cases against Ms. Caluyong.
This 2-page document is a clearance form from the Department of Education for Jean C. Caluyong, a principal at Esperanza Elementary School. [1] It details the purpose of clearance as a transfer to a new school. [2] Supervisors from Esperanza Elementary School and the Schools Division Office certify that Ms. Caluyong is cleared of all work-related responsibilities. [3] Officials from various offices, including Administration, Library Services, and Finance, certify that Ms. Caluyong has no outstanding monetary or property obligations. [4] The agency head signs to certify there are no pending administrative cases against Ms. Caluyong.
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CS Form No.
7 Series of 2017
Department of Education Caraga Administrative Region Schools Division Office of Dinagat Islands Loreto District CLEARANCE FORM (Instructions at the back)
I PURPOSE
June 30,2019 Date of Application
TO: ESPERANZA ELEMENTARY SCHOOL / LORETO DISTRICT
I hereby apply for clearance from money, property and work-related accountabilities for: Purpose: £ Transfer £ Resignation £ Other Mode of Separation:
As Principal I transferred to Dina
£ Retirement £ Leave Please specify: Central ES vice Saturnino Mut Effectivity/Inclusive Peri 30-Jun-19
Office of Assignment: ESPERANZA ELEMENTARY SCHOOL
JEAN C. CALUYONG Position/SG/Ste PRINCIPAL-I 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.
JEAN C. CALUYONG EMMA A. DALUGDUGAN
Principal-I Public Schools District Supervisor III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES Name of Unit/Office/Department Cleared Not Cleared Name of Clearing Officer/Official 1. Administration Sector
Supply and Property Procurement and MYRNA D. GAHUMAN
a. Management Services /
b. Human Resource Welfare & Assistance
c. Agency-accredited Union/Cooperative 2. Library
a. Legal Office Library
TEOFANES M. MONDALA b. Library Services / 3. Finance and Assets Management
GERALYN M. PATUAL a. Financial Services /
b. Transaction, Processing & Billing Services
JOYCEE A. CHENIDO c. Payroll & Remittance Services / 4. Professional and Institutional Development
a. Scholarship Services IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:
a. Internal Affairs Office/Legal Affairs Office
with pending administrative case with ongoing investigation (no formal charge yet)
V CERTIFICATION
KAREN L. GALANIDA,Ph.D.,CESO VI Signature over Printed Name of Agency Head rtment of Education Administrative Region ion Office of Dinagat Islands Loreto District ARANCE FORM nstructions at the back)
Date of Application
As Principal I transferred to Dinagat
Central ES vice Saturnino Mutia
JEAN C. CALUYONG Name and Signature of Employee
work-related accountabilities from this Unit/Office/Dept.
EMMA A. DALUGDUGAN Public Schools District Supervisor
Signature GALANIDA,Ph.D.,CESO VI Printed Name of Agency Head
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.
