CSC Clearance Form
CSC Clearance Form
CSC Clearance Form
7
Series
Seriesofof2017
2017 Republic of the Philippines
Department of Education
Region IV - CALABARZON
SCHOOLS DIVISION OF LAGUNA
Sta. Cruz
CLEARANCE FORM
(Instructions at the back)
I PURPOSE:
Date of Application
TO: DEPED - SDO LAGUNA
(Agency Name)
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:
ANGELA F. LATINA
b. Human Resource Welfare & Assistance Administrative Officer V
c. Agency-accredited Union/Cooperative
2. Library
b. Library Services
3. Finance and Assets Management
IRENE A. FERNANDEZ
a. Financial Services Accountant III
IRENE A. FERNANDEZ
b. Transaction, Processing & Billing Services Accountant III
IRENE A. FERNANDEZ
c. Payroll & Remittance Services Accountant III
4. Professional and Institutional Development
a. Scholarship Services
IV CERTIFICATION OF NO PENDING ADMINISTRATIVE CASE:
V CERTIFICATION
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.)
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