Documente Academic
Documente Profesional
Documente Cultură
7
Seriesofof2017
Series 2017
Agency Name
CLEARANCE FORM
(Instructions at the back)
I PURPOSE
Date of Application
TO: SCHOOLS DIVISION OF QUEZON
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 Period: __________________________________________________________
_______________________________ _______________________________
Immediate Supervisor Head of Office
III CLEARANCE FROM MONEY AND PROPERTY ACCOUNTABILITIES
Not Name of Clearing
Name of Unit/Office/Department Cleared Cleared Officer/Official
1. Administration Sector
Supply and Property Procurement and
a. Management Services GEORGE D. AGUILA
V CERTIFICATION
Date of Application
JHONATHAN S. CADAVIDO
Name and Signature of Employee
_______________________________
Head of Office
Signature
s Division Superintendent
ver Printed Name of Agency Head
Page 1 of 2
INSTRUCTIONS:
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.)