Department of Education

Region VI- Western Visayas

Division of Negros Occidental
ENRIQUETA MONTILLA DE ESTEBAN MEMORIAL HIGH SCHOOL
Riego St. Brgy. Zone 2, Pulupandan, Negros Occidental
TEACHER'S YEAR END CLEARANCE
THE REGIONAL DIRECTOR
Department of Education
Region VI- Western Visayas
Duran St., Ilo-ilo City
(Through Channel)

SIR:
I have the honor to advise you that I have satisfactorily settled accounts for money and property for which was responsible on
this Division and that all reports of me were submitted on the dates below;
A.

C.

Accounting Documents
1 Form 48
2 Community Tax A & B
3 SALN

B.

LAURIE ANN N. OCTAVIANO

Library & Property Inventory

15 Books/References/IM
16 Property Inventory

LILIAN A. DULOSA

School Records/ Forms Paraphernalia

DIANA V. MACALANGGAN
4 Form 1 & 2
Form
137
5
MARILYN N. GALVEZ
6 Form 138
7 Form 5
CARMEN C. TEOSO
8 Class Records/ Grade Sheets
9 Instruction Plan/Log
MARITESS C. PINEDA
10 Test Notebook/ Item Bank
11 Orientation List/ Rank List
Grade 7
NATY C. ROSALES
Grade 8
LOUREY M. VILLARAIZ
Third Year
SARAH M. VILLARUEL
JOCELYN D. ROBETE
Fourth Year
12 PAST w/ MOVs
MARILYN N. GALVEZ
13 Performance Contract
14 Monthly Accomplishment Report

D.

Financial Report
17 Raffle Ticket (EMEMHS Night)
18 Cooperative Membership
19 Canteen Funds
20 High School Day Collection (per Teacher)
21 JS Prom
22 Graduation Expenses

E.

Medical Requirements
23 X-Ray Result/ Urine/ Stole/ CBC

Until further notice, my mailing address will be

Very Truly Yours,

EMILIANO D. SONGALING
Property Custodian

(SignatureOver Printed Name)

MARITESS C. PINEDA
Librarian

JOSEPHINE H. JARDELIZA
Guidance Counselor

DIANA V. MACALANGGAN
Records In-Charge

LAURIE ANN N. OCTAVIANO

Disbursing Officer

LILIAN A. DOLOSA
Bookeeper

MARILYN N. GALVEZ
Principal

ventory
MARITESS C. PINEDA
EMILIANO D. SONGALING

S Night)
hip

ction (per Teacher)

MARITESS C. PINEDA
SARAH M. VILLARUEL
JENNY T. ALVAREZ
MARILYN N. GALVEZ

tole/ CBC

Printed Name)

JARDELIZA
ounselor
OCTAVIANO
Officer

GALVEZ
pal

INVENTORY OF CLASSROOM/ SCHOOL PROPERTIES

A. BOOK/ INSTRUCTIONAL MATERIALS
NAME/ TITTLE

QUANTITY

ACQUISITION

DATE RECEIVED

I. BOOKS

II. FURNITURES/EQUIPMENT/TOOLS

III. LOST BOOKS

I hereby certify that the school properties above are in

Very Truly Yours,

(SignatueOver Printed Na

1st Indorsement
Division of Negros Occidental
Bacolod City
Respectfully forwarded to the Regional Director- DepEd Region VI- Western Visayas, Duran St.,
Ilo-ilo City, with the information that the last day of service of this teacher in this Division was
.
The forgoing statement is correct and a complete clearance is hereby granted.
NOTED:

GENE E. ESPINOSA
Teacher In-Charge
Recommending Approval:

MICHELLE L. ACOYONG
OIC Asst. Schools Division Superintendent
APPROVED:
ANTHONY H. LIOBET, CESO VI
Schools Division Superintendent

CONDITION

(SignatueOver Printed Name)

GENE E. ESPINOSA
Teacher In-Charge

BET, CESO VI
uperintendent

REMARKS

Department of Education
Region VI- Western Visayas
Division of Negros Occidental
ENRIQUETA MONTILLA DE ESTEBAN MEMORIAL HIGH SCHOOL
Riego St. Brgy. Zone 2, Pulupandan, Negros Occidental

TEACHER'S YEAR END CLEARANCE

THE REGIONAL DIRECTOR
Department of Education
Region VI- Western Visayas
Duran St., Ilo-ilo City
(Through Channel)
SIR:
I have the honor to advise you that I have satisfactorily settled accounts for money and property for which was responsible on this Division
and that all reports of me were submitted on the dates below;
A. Accounting Documents
1 Form 48
2 Community Tax A & B

LAURIE ANN N. OCTAVIANO

3 SALN

LILIAN A. DULOSA
B. School Records/ Forms Paraphernalia

4 Form 1 & 2

JOSEPHINE H. JARDELIZA

5 Form 137
6 Form 138
7 SF 5

GENE E. ESPINOSA

8 Miscellaneous Fees
9 Class Records/ Grade Sheets

DIANA V. MACALAGGAN
MT's

10 Instruction Plan/Log
11 Test Notebook/ Item Bank
12 Orientation List/ Rank List

MT's
MT's

Grade 7

NATY C. ROSALES

Grade 8

LOUREY M. VILLARAIZ

Third Year

GLORY E. DELIMA

Fourth Year

SARAH M. VILLARUEL

13 PAST w/ MOVs
GENE E. ESPINOSA

14 Performance Contract
15 Monthly Accomplishment Report/ Per Dept.
C. Library & Property Inventory
16 Books/References/IM
17 Property Inventory

SUZETTA T. DETABLAN
EMILIANO D. SONGALING
D. Financial Report

18 EMEMHS Night

MARITESS C. PINEDA

19 Cooperative Membership

SARAH M. VILLARUEL

20 Canteen Funds
21 High School Day Collection (per Teacher)

JENNY T. ALVAREZ

22 Graduation Expenses/Financial Reports

GENE E. ESPINOSA

E. Medical Requirements
23 X-Ray Result / Urine / Stool / CBC
Until further notice, my mailing address will be

Very Truly Yours,

(SignatureOver Printed Name)

EMILIANO D. SONGALING
Property Custodian

JOSEPHINE H. JARDELIZA
Guidance Counselor

SUZETTA T. DETABLAN
Librarian

LAURIE ANN N. OCTAVIANO

Disbursing Officer

DIANA V. MACALANGGAN
Records In-Charge

LILIAN A. DOLOSA
Bookeeper

GENE E. ESPINOSA
Principal

Printed Name)

JARDELIZA
Counselor

OCTAVIANO
g Officer

DOLOSA
eper