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    Clearance Form: I Purpose

    Uploaded by

    Lilian May Sorote Ando
    This document is a clearance form used by the Department of Education Leyte Division Office. [1] It requires employees who are transferring, resigning, retiring or taking other types of separation to be cleared of any work-related or financial accountabilities. [2] The form has different sections for employees to be cleared by their immediate supervisor and department head of any work duties or projects. [3] It also requires sign-offs from various offices and units like Administration, Finance, and Legal to ensure the employee has no pending debts or obligations in those areas.

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

    Clearance Form: I Purpose

    Uploaded by

    Lilian May Sorote Ando
    145 views6 pages
    This document is a clearance form used by the Department of Education Leyte Division Office. [1] It requires employees who are transferring, resigning, retiring or taking other types of separation to be cleared of any work-related or financial accountabilities. [2] The form has different sections for employees to be cleared by their immediate supervisor and department head of any work duties or projects. [3] It also requires sign-offs from various offices and units like Administration, Finance, and Legal to ensure the employee has no pending debts or obligations in those areas.

    Original Description:

    CLEARANCE FORM

    Original Title

    cs

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    This document is a clearance form used by the Department of Education Leyte Division Office. [1] It requires employees who are transferring, resigning, retiring or taking other types of separation to be cleared of any work-related or financial accountabilities. [2] The form has different sections for employees to be cleared by their immediate supervisor and department head of any work duties or projects. [3] It also requires sign-offs from various offices and units like Administration, Finance, and Legal to ensure the employee has no pending debts or obligations in those areas.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    145 views6 pages

    Clearance Form: I Purpose

    Uploaded by

    Lilian May Sorote Ando
    This document is a clearance form used by the Department of Education Leyte Division Office. [1] It requires employees who are transferring, resigning, retiring or taking other types of separation to be cleared of any work-related or financial accountabilities. [2] The form has different sections for employees to be cleared by their immediate supervisor and department head of any work duties or projects. [3] It also requires sign-offs from various offices and units like Administration, Finance, and Legal to ensure the employee has no pending debts or obligations in those areas.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    of 6

    CS Form No.

    7
    Series of 2017
    DEPARTMENT OF EDUCATION
    LEYTE DIVISION OFFICE
    CLEARANCE FORM
    (Instructions at the back)

    I PURPOSE

    Date of Application
    TO: (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: __________________________________________________________

    Office of Assignment: ____________________________


    ______________________________________
    Position/SG/Step: ____________________________ 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.

    _______________________________ _______________________________
    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

    1. Administration Sector

    Supply and Property Procurement and


    a. Management Services

    b. Human Resource Welfare & Assistance

    c. Agency-accredited Union/Cooperative
    2. Library

    a. Legal Office Library

    b. Library Services
    3. Finance and Assets Management

    a. Financial Services

    b. Transaction, Processing & Billing Services

    c. Payroll & Remittance Services


    4. Professional and Institutional Development

    a. Scholarship 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

    _________________________________
    Signature over Printed Name of Agency Head
    ARTMENT OF EDUCATION
    EYTE DIVISION OFFICE
    EARANCE FORM
    (Instructions at the back)

    Date of Application

    Please specify: __________________________


    ________________________________________________

    ______________________________________
    Name and Signature of Employee

    ed of work-related accountabilities from this Unit/Office/Dept.

    _______________________________
    Head of Office

    Signature
    ________________________
    r Printed Name of Agency Head

    Page 1 of 2
    INSTRUCTIONS:

    1. Employees who are retiring, being separated, transferring to other agencies,


    leaving the Philippines and going on maternity leave of absence shall prepare
    this form in quadruplicate.

    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.)

    3. If the employees are cleared from a unit/office/department, the


    clearing/authorized official may attach to this clearance the pertinent
    document/s that shall prove that the employees are cleared of any obligation
    or accountability from their office, if any, and tick the box under the "Cleared"
    column before affixing their signatures.

    4. If the employees appear to have uncleared accountability/ies from a


    unit/office/department, the clearing/authorized official shall attach to this
    clearance the pertinent document/s that shall prove that the employees have
    remaining obligation or accountability from their office further indicating the
    necessary action/s that the employee must satisfy in order to be cleared, and
    tick the box under the "Uncleared" column. The clearing/authorized official
    must only sign this clearance corresponding to their name once the employee
    have complied the necessary requirements and cleared of all the obligation/s
    and accountability/ies from their office. They must also tick the box under the
    "Cleared" column.

    5. The HRMO shall distribute copies of approved clearance as follows: original


    to the employee; duplicate to be attached to the payroll or voucher; triplicate
    to human resource unit file; and fourth copy to accounting/auditing office.

    6. Processing of clearance certificate shall follow the order of number indicated.


    Page 2 of 2

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