Republic of the Philippines

Department of Education
National Capital Region
DIVISION OF LAS PIAS
ALMANZA ELEMENTARY SCHOOL- TS CRUZ ANNEX
Ilang-ilang St. TS Cruz Subd. Almanza II Las Pias City
Telephone: 772-1897/ Email: atscruzannex@yahoo.com

April 4, 2016
Date
TO WHOM IT MAY CONCERN,
This is to certify that I have satisfactorily accomplished all assignments, submitted
all reports required of me, and have accounted for all money and property responsibility on
which I was responsible in the school.
I.

II.

Guidance Office: Ms. Herwina R. Simbillo

Date Submitted

Signature
SF 1 (3 copies) (new download)
______________________
_____________________
SF 2 (June-March)..
______________________
____________________
SF 5 (size A3- 2 copies)
______________________
_____________________
LIS (download SF5 with Average)..
______________________
_____________________
Form 137.
______________________
_____________________
Class Record Book (1st-4th Grading)
______________________
_____________________
Grading Sheet ....
______________________
_____________________
Unclaimed Cards ..
______________________
_____________________

Property Custodian: Mrs. Catalina L. Quindoy

Books /SF 3
______________________
_____________________
Tools/Equipment ..
______________________
III.
School
Facilities: Mrs. Gloria C. Benore
_____________________
Chairs/table...
______________________
_____________________
Classroom Inventory .
______________________

IV.

School Accounts: Mrs. Mechiel C. Paraiso

V.

Death Aid-LPTO..
______________________
Federation

Canteen: Ms. Mary Rose Y. Roloyan

VI.

Cups..
______________________
Clinic:
OthersMrs.
...
Wilfreda M. Villarin

X-ray /Urinalysis/CBC...
_____________________
Vision/Auditory Summary ...
VII. Office:
Mr. Eduardo A. Tocayon
_____________________
IPCRF with Portfolio..
_____________________
PLC. ....
_____________________

______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________

I HEREBY CERTIFY THAT MY ROOM IS PROPERLY CLEANED AND LOCKED WITH THE
ABOVE PROPERTIES AS STATED IN THE ROOM INVENTORY. My residence and mailing
address will be ______________________ Las Pias City and my contact number is
__________________.
Very truly yours,
ANGELO C.
CASTILLOTE
Recommending Approval:

Signature Over Printed Name

EDUARDO A. TOCAYON
MT-I, TIC