Scribd Logo
Upload

Welcome to Scribd!

  • 26 views

    Local Media1391281082273294204

    Uploaded by

    Rein Ashlie Gera
    This document is a clearance form used by the Department of Education in Siargao, Philippines. It consists of 5 sections for clearing an employee from work-related, money, and property accountabilities for purposes of transfer, resignation, retirement, or leave. Section I provides employee and clearance request details. Section II is for clearing work-related accountabilities from the employee's unit/office. Section III clears the employee from money and property accountabilities in different departments. Section IV certifies there are no pending administrative cases against the employee. Section V provides final certification of clearing from all accountabilities by the agency head.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd

    Local Media1391281082273294204

    Uploaded by

    Rein Ashlie Gera
    26 views5 pages
    This document is a clearance form used by the Department of Education in Siargao, Philippines. It consists of 5 sections for clearing an employee from work-related, money, and property accountabilities for purposes of transfer, resignation, retirement, or leave. Section I provides employee and clearance request details. Section II is for clearing work-related accountabilities from the employee's unit/office. Section III clears the employee from money and property accountabilities in different departments. Section IV certifies there are no pending administrative cases against the employee. Section V provides final certification of clearing from all accountabilities by the agency head.

    Original Description:

    Original Title

    local_media1391281082273294204

    Copyright

    © © All Rights Reserved

    Available Formats

    XLS, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is a clearance form used by the Department of Education in Siargao, Philippines. It consists of 5 sections for clearing an employee from work-related, money, and property accountabilities for purposes of transfer, resignation, retirement, or leave. Section I provides employee and clearance request details. Section II is for clearing work-related accountabilities from the employee's unit/office. Section III clears the employee from money and property accountabilities in different departments. Section IV certifies there are no pending administrative cases against the employee. Section V provides final certification of clearing from all accountabilities by the agency head.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    26 views5 pages

    Local Media1391281082273294204

    Uploaded by

    Rein Ashlie Gera
    This document is a clearance form used by the Department of Education in Siargao, Philippines. It consists of 5 sections for clearing an employee from work-related, money, and property accountabilities for purposes of transfer, resignation, retirement, or leave. Section I provides employee and clearance request details. Section II is for clearing work-related accountabilities from the employee's unit/office. Section III clears the employee from money and property accountabilities in different departments. Section IV certifies there are no pending administrative cases against the employee. Section V provides final certification of clearing from all accountabilities by the agency head.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    of 5

    CS Form 7

    Revised 2018
    Series of 2017
    Department of Education
    DEPED SIARGAO
    DIVISION CLEARANCE FORM

    I PURPOSE

    Date of Filing
    TO: _________________________________________________
    I hereby request clearance from money, property and work-related accountabilities for:
    Purpose: £ Transfer £ Resignation £ Other Mode of Separation:
    £ Retirement £ Leave Please specify: __________________________
    Date of Effectivity : __________________________________________________________

    Office of Assignment: ____________________________


    ______________________________________
    Position/SG/Step: ____________________________ Name and Signature of Employee
    II CLEARANCE FROM WORK-RELATED ACCOUNTABILITIES
    We hereby certify that this employee is cleared _____ / not cleared of work-related accountabilities from this
    Unit/Office/Dept.

    _______________________________ _______________________________
    Immediate Supervisor Public Schools District Supervisor

    III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES


    Not
    Name of Unit/Office/Department Cleared Cleared
    Name of Clearing Officer/Official Signature
    1. Administrative Services
    Supply and Property Procurement and FRANCIS ALBERT C. GOLO - AO IV -AO II
    a. Management Services
    DEANA LUXZEL T. SOLIS - LIBRARIAN II /
    b. Human Resource Welfare & Assistance HRMO II - Designate

    MIGUELA S. LIGUTOM - AO V
    c. General Administrative Services
    2. Finance and Assets Management
    RYAN S. DUMADAG - Administrative Officer
    a. Financial Services II / Accountant Designate

    MARICIRIS O. SULAPAS, CPA - Cashier


    b. Transaction, Processing & Billing Services
    JEANETTE C. GOCELA - AO II- Payroll
    c. Payroll & Remittance Services Officer
    IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:

    ATTY. JEDDAH MAY NANGAS - Attorney III


    a. Internal Affairs Office/Legal Affairs Office
    with pending administrative case
    with ongoing investigation (no formal charge yet)

    V CERTIFICATION

    I hereby certify that this employee is cleared of work-related, money, property accountabilities form this agency. This certification includes
    no pending administrative case from this agency.

    NELIA S. LOMOCSO, PhD, CESO V


    Schools Division Superintendent
    Signature over Printed Name of Agency Head
    CS Form 7
    Revised 2018
    Series of 2017
    Department of Education
    DEPED SIARGAO
    SCHOOL / DISTRICT CLEARANCE FORM

    I PURPOSE

    Date of Filing
    TO: _________________________________________________
    I hereby request clearance from money, property and work-related accountabilities for:
    Purpose: £ Transfer £ Resignation £ Other Mode of Separation:
    £ Retirement £ Leave Please specify: __________________________
    Date of Effectivity : __________________________________________________________

    Office of Assignment: ____________________________


    ______________________________________
    Position/SG/Step: ____________________________ Name and Signature of Employee
    II CLEARANCE FROM WORK-RELATED ACCOUNTABILITIES
    We hereby certify that this employee is cleared _____ / not cleared of work-related accountabilities from this
    Unit/Office/Dept.

    _______________________________ _______________________________
    Immediate Supervisor School Principal / School Head

    III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES


    Not
    Name of Unit/Office/Department Cleared Cleared
    Name of Clearing Officer/Official Signature
    1. Administrative Services
    Supply and Property Procurement and
    a. Management Services

    b. Human Resource Welfare & Assistance

    c. General Administrative Services


    2. Finance and Assets Management

    a. Financial Services

    b. Transaction, Processing & Billing Services

    c. Payroll & Remittance 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

    I hereby certify that this employee is cleared of work-related, money, property accountabilities form this agency. This certification includes
    no pending administrative case from this agency.

    _________________________________________
    Signature over Printed Name of PSDS
    CS Form No. 7
    Series of 2017
    Series of 2017 SAMPLE
    Local Government Unit
    City of San Fernando, Pampanga
    CLEARANCE FORM

    I PURPOSE

    November 20, 2017


    Date of Application
    TO: City Government of San Fernando, Pampanga
    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 Per Travel Abroad /December 18-22, 2017

    Office of Assignment: City Human Resource Development Office


    Carolyn H. Rosales
    Position/SG/Step: Administrative Assistant II /8/5 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.

    Hazel S. Mallari Rachelle S. Yusi


    Immediate Supervisor Head of Office
    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 Engr. Michael N. Quizon


    a. Management Services

    Ms. Rachelle S. Yusi


    b. Human Resource Welfare & Assistance

    Ms. Maria Teresa Q. Doble


    c. Agency-accredited Union/Cooperative
    2. Library

    N/A N/A N/A N/A


    a. Legal Office Library

    N/A N/A N/A N/A


    b. Library Services
    3. Finance and Assets Management

    Ms. Maria Gisel P. Rivera


    a. Financial Services

    Ms. Mary Ann P. Bautista


    b. Transaction, Processing & Billing Services

    Ms. Rachelle S. Yusi / Ms. Maria Gisel P. Rivera /


    c. Payroll & Remittance Services
    4. Professional and Institutional Development

    Ms. Rachelle S. Yusi


    a. Scholarship Services
    IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:

    Atty. Atlee T. Viray


    a. Internal Affairs Office/Legal Affairs Office
    with pending administrative case
    with ongoing investigation (no formal charge yet)

    V CERTIFICATION

    EDWIN D. SANTIAGO
    Signature over Printed Name of Agency Head

    You might also like