Report Code: SFCR1 Annex 1a

SCHOOL FORMS CHECKING REPORT

SCHOOL NAME: CATMON INTEGRATED SCHOOL SCHOOL ID:

Table 1. Learner Records Examined/Reviewed

Grade No. of Examined/Reviewed*

Section Name of Adviser Date Checked
Level
Male Female
GR. 12 AMETHYST DINAH C. ARMILLA
GR.12 DIAMOND JENNIFER QUINAIN May 14,2024 23 21
GR.12 GARNET RIZA P. LUARDO
GR. 12 OPAL HERNANDEZ JR. B. COLOLOT
GR. 12 RUBY JOAN P. COMENDADOR
GR. 12 TOPAZ JINKY C. MOLINAS
GR. 12 PEARL (ICT) KHALILAH P. LUCERNAS
GR. 12 AMBER JULIET A. WAGAS
GR. 12 AQUAMARINE ( C
JOY S. ACUESTA
School Total

Table 2. Learner Records with Inconsistency/ies or Errors

No. of Records per Nature of Errors*
Grade
Section Name of Adviser With Incomplete Supporting
Level With Inconsistent/Error
Documents
GR. 12 AMETHYST DINAH C. ARMILLA
GR.12 DIAMOND JENNIFER QUINAIN 0 0
GR.12 GARNET RIZA P. LUARDO
GR. 12 OPAL HERNANDEZ JR. B. COLOLO
GR. 12 RUBY JOAN P. COMENDADOR
GR. 12 TOPAZ JINKY C. MOLINAS
GR. 12 PEARL (ICT) KHALILAH P. LUCERNAS
GR. 12 AMBER JULIET A. WAGAS
GR. 12 AQUAMARINE ( C
JOY S. ACUESTA

*Do not included Temporary Enrolled Learners as defined in Deped Order No. 3, s. 2018.
** % Accuracy refers to the percentage of correct/consistent records over total records examined or reviewed.

Table 3. For Transferred in/Moved in

Transfer of SF 10 (Formerly Form 137)
Without SF10**
Grade With SF 10
Section Name of Adviser (For Temporary En
Level
Received w/in Received beyond
From Private School
30 days 30 days
GR. 12 AMETHYST DINAH C. ARMILLA
GR.12 DIAMOND JENNIFER QUINAIN
GR.12 GARNET RIZA P. LUARDO
GR. 12 OPAL HERNANDEZ JR. B. COLOLOT
GR. 12 RUBY JOAN P. COMENDADOR
GR. 12 TOPAZ JINKY C. MOLINAS
GR. 12 PEARL (ICT) KHALILAH P. LUCERNAS
Report Code: SFCR1 Annex 1a

GR. 12 AMBER JULIET A. WAGAS

GR. 12 AQUAMARINE ( C
JOY S. ACUESTA

***Do not include PEPT/PVT or ALS-A&E Certificate holders.

Table 4. For Transferred in/Moved In Learners Without SF 10 (formerly Form 137)

Grade
Section Name of Adviser LRN Name of Learner
Level
GR. 12 AMETHYST DINAH C. ARMILLA
GR.12 DIAMOND JENNIFER QUINAIN
GR.12 GARNET RIZA P. LUARDO
GR. 12 OPAL HERNANDEZ JR. B. COLOLOT
GR. 12 RUBY JOAN P. COMENDADOR
GR. 12 TOPAZ JINKY C. MOLINAS
GR. 12 PEARL (ICT) KHALILAH P. LUCERNAS
GR. 12 AMBER JULIET A. WAGAS
GR. 12 AQUAMARINE ( C
JOY S. ACUESTA

Type of Checking Committee: / School Checking Committee (SCC)

Prepared by:

MARIA CHERILONA P. ESTOR THEA MAE C. ARENILLA TIFFANY ANNE C. COLITA

Chairman Vice Chairman Member
…………………………………………………………………………….. All fields below are solely for the use of the Division Checking Committee (D
Conforme:
TERESITA B. MONISIT
Principal II
 Report Code: SFCR1 Annex 1a

CHECKING REPORT

500042 DISTRICT: CATMON

mined/Reviewed* No. with Inconsistency or Incomplete

Supporting Documents % Accuracy**
Total Male Female Total

44 0 0 0

r Nature of Errors*
DCC Observation/Comment or Technical Assistance
th Inconsistent/Error Total Provided
Lacking PSA Birth Certificate & ICT Coord. gave assistance
wrong bdate at LIS
0 0

Formerly Form 137)

ithout SF10**
(For Temporary Enrolled) DCC Observation/Comment or Technical Assistance
Provided
From Public
School/SUC/LUC
 Report Code: SFCR1 Annex 1a

Name of Originating School School ID Division/Region

king Committee (SCC) Division Checking Committee (DCC)

TIFFANY ANNE C. COLITA CARMELLE R. ARIBAL DINAH ARMILLA

Member Member Member
of the Division Checking Committee (DCC)……………………………………………………………………………..

Date Completed (School Level)

Report Code: SFCR1 Annex 1a

SCHOOL FORMS CHECKING REPORT

SCHOOL NAME: CATMON INTEGRATED SCHOOL SCHOOL ID:

Table 1. Learner Records Examined/Reviewed

Grade No. of Examined/Reviewed*

Section Name of Adviser Date Checked
Level
Male Female
GR. 10 AMBER JAINA R. PUABEN
GR. 10 AMETHYST KATHLEEN ROSE S. FLORES
GR. 10 AQUAMARINE RHALP KEVIN A. LAPING
GR. 10 GARNET CHERRY ANN D. MENORIA
GR. 10 OPAL MA. DOREEN S. ALBURO
GR. 10 PEARL THEA MAE C. ARENILLA
GR.10 TOPAZ MARJORIE B. LUCERO

School Total

Table 2. Learner Records with Inconsistency/ies or Errors

No. of Records per Nature of Errors*
Grade
Section Name of Adviser With Incomplete Supporting
Level With Inconsistent/Error
Documents
GR. 10 AMBER JAINA R. PUABEN
GR. 10 AMETHYST KATHLEEN ROSE S. FLORES
GR. 10 AQUAMARINE RHALP KEVIN A. LAPING
GR. 10 GARNET CHERRY ANN D. MENORIA
GR. 10 OPAL MA. DOREEN S. ALBURO
GR. 10 PEARL THEA MAE C. ARENILLA
GR.10 TOPAZ MARJORIE B. LUCERO

*Do not include Temporary Enrolled Learners as defined in Deped Order No. 3, s. 2018.
** % Accuracy refers to the percentage of correct/consistent records over total records examined or reviewed.

Table 3. For Transferred in/Moved in

Transfer of SF 10 (Formerly Form 137)
Without SF10**
Grade With SF 10
Section Name of Adviser (For Temporary En
Level
Received w/in Received beyond
From Private School
30 days 30 days
GR. 10 AMBER JAINA R. PUABEN
GR. 10 AMETHYST KATHLEEN ROSE S. FLORES
GR. 10 AQUAMARINE RHALP KEVIN A. LAPING
GR. 10 GARNET CHERRY ANN D. MENORIA
GR. 10 OPAL MA. DOREEN S. ALBURO
GR. 10 PEARL THEA MAE C. ARENILLA
Report Code: SFCR1 Annex 1a

GR.10 TOPAZ MARJORIE B. LUCERO

***Do not include PEPT/PVT or ALS-A&E Certificate holders.

Table 4. For Transferred in/Moved In Learners Without SF 10 (formerly Form 137)

Grade
Section Name of Adviser LRN Name of Learner
Level
GR. 10 AMBER JAINA R. PUABEN
GR. 10 AMETHYST KATHLEEN ROSE S. FLORES
GR. 10 AQUAMARINE RHALP KEVIN A. LAPING
GR. 10 GARNET CHERRY ANN D. MENORIA
GR. 10 OPAL MA. DOREEN S. ALBURO
GR. 10 PEARL THEA MAE C. ARENILLA
GR.10 TOPAZ MARJORIE B. LUCERO

Type of Checking Committee: / School Checking Committee (SCC)

Prepared by:

MARIA CHERILONA P. ESTOR THEA MAE C. ARENILLA TIFFANY ANNE C. COLITA

Chairman Vice Chairman Member
…………………………………………………………………………….. All fields below are solely for the use of the Division Checking Committee (D
Conforme:
TERESITA B. MONISIT
Principal II
 Report Code: SFCR1 Annex 1a

CHECKING REPORT

500042 DISTRICT: CATMON

amined/Reviewed* No. with Inconsistency or Incomplete

Supporting Documents % Accuracy**
Total Male Female Total

er Nature of Errors*
DCC Observation/Comment or Technical Assistance
ith Inconsistent/Error Total Provided
Lacking PSA Birth Certificate & ICT Coord. gave assistance
wrong bdate at LIS

(Formerly Form 137)

Without SF10**
(For Temporary Enrolled) DCC Observation/Comment or Technical Assistance
Provided
From Public
School/SUC/LUC
 Report Code: SFCR1 Annex 1a

Name of Originating School School ID Division/Region

cking Committee (SCC) Division Checking Committee (DCC)

TIFFANY ANNE C. COLITA

Member Member Member
of the Division Checking Committee (DCC)……………………………………………………………………………..

Date Completed (School Level)

Report Code: SFCR1 Annex 1a

SCHOOL FORMS CHECKING REPORT

SCHOOL NAME: CATMON INTEGRATED SCHOOL SCHOOL ID:

Table 1. Learner Records Examined/Reviewed

Grade No. of Examined/Reviewed*

Section Name of Adviser Date Checked
Level
Male Female
11 AMBER BRIDGET ZOE D. MODEQUILLO
11 AMETHYST JARAMIE JULY V. GEONZON
11 GARNET JONHA G. NAVAJA
11 OPAL CARMELLE R. ARIBAL
11 RUBY REIGNA G. ARANETA

11 AQUAMARINE ( ERLINDA A. ALDUCENTE

11 PEARL (ICT) CHARMIE JEAN B. PONTEMAYOR
11 TOPAZ (ICT) SHEBA A. SUMALINOG
School Total

Table 2. Learner Records with Inconsistency/ies or Errors

No. of Records per Nature of Errors*
Grade
Section Name of Adviser With Incomplete Supporting
Level With Inconsistent/Error
Documents
11 AMBER BRIDGET ZOE D. MODEQUILLO
11 AMETHYST JARAMIE JULY V. GEONZON
11 GARNET JONHA G. NAVAJA
11 OPAL CARMELLE R. ARIBAL
11 RUBY REIGNA G. ARANETA

11 AQUAMARINE ( ERLINDA A. ALDUCENTE

11 PEARL (ICT) CHARMIE JEAN B. PONTEMAYOR
11 TOPAZ (ICT) SHEBA A. SUMALINOG

*Do not included Temporary Enrolled Learners as defined in Deped Order No. 3, s. 2018.
** % Accuracy refers to the percentage of correct/consistent records over total records examined or reviewed.

Table 3. For Transferred in/Moved in

Transfer of SF 10 (Formerly Form 137)
Without SF10**
Grade With SF 10
Section Name of Adviser (For Temporary En
Level
Received w/in Received beyond
From Private School
30 days 30 days
11 AMBER BRIDGET ZOE D. MODEQUILLO
11 AMETHYST JARAMIE JULY V. GEONZON
11 GARNET JONHA G. NAVAJA
11 OPAL CARMELLE R. ARIBAL
11 RUBY REIGNA G. ARANETA

11 AQUAMARINE ( ERLINDA A. ALDUCENTE

Report Code: SFCR1 Annex 1a

11 PEARL (ICT) CHARMIE JEAN B. PONTEMAYOR

11 TOPAZ (ICT) SHEBA A. SUMALINOG

***Do not include PEPT/PVT or ALS-A&E Certificate holders.

Table 4. For Transferred in/Moved In Learners Without SF 10 (formerly Form 137)

Grade
Section Name of Adviser LRN Name of Learner
Level
11 AMBER BRIDGET ZOE D. MODEQUILLO
11 AMETHYST JARAMIE JULY V. GEONZON
11 GARNET JONHA G. NAVAJA
11 OPAL CARMELLE R. ARIBAL
11 RUBY REIGNA G. ARANETA

11 AQUAMARINE ( ERLINDA A. ALDUCENTE

11 PEARL (ICT) CHARMIE JEAN B. PONTEMAYOR
11 TOPAZ (ICT) SHEBA A. SUMALINOG

Type of Checking Committee: / School Checking Committee (SCC)

Prepared by:

MARIA CHERILONA P. ESTOR THEA MAE C. ARENILLA TIFFANY ANNE C. COLITA

Chairman Vice Chairman Member
…………………………………………………………………………….. All fields below are solely for the use of the Division Checking Committee (D
Conforme:
TERESITA B. MONISIT
Principal II
 Report Code: SFCR1 Annex 1a

CHECKING REPORT

500042 DISTRICT: CATMON

mined/Reviewed* No. with Inconsistency or Incomplete

Supporting Documents % Accuracy**
Total Male Female Total

r Nature of Errors*
DCC Observation/Comment or Technical Assistance
th Inconsistent/Error Total Provided
Lacking PSA Birth Certificate & ICT Coord. gave assistance
wrong bdate at LIS

Formerly Form 137)

ithout SF10**
(For Temporary Enrolled) DCC Observation/Comment or Technical Assistance
Provided
From Public
School/SUC/LUC
 Report Code: SFCR1 Annex 1a

Name of Originating School School ID Division/Region

king Committee (SCC) Division Checking Committee (DCC)

TIFFANY ANNE C. COLITA CARMELLE R. ARIBAL

Member Member Member
of the Division Checking Committee (DCC)……………………………………………………………………………..

Date Completed (School Level)

Report Code: SFCR1 Annex 1a

SCHOOL FORMS CHECKING REPORT

SCHOOL NAME: CATMON INTEGRATED SCHOOL SCHOOL ID:

Table 1. Learner Records Examined/Reviewed

Grade No. of Examined/Reviewed*

Section Name of Adviser Date Checked
Level
Male Female
9 AMBER MELVIC L. BUIZA
9 AMETHYST EVELYN L. ARENILLA
9 GARNET TIFFANY ANNE C. COLITA
9 OPAL MICHELLE S. DONGALLO
9 PEARL ZENDA C. AYING
9 TOPAZ HAZEL P. GARANGANAO
9 AQUAMARINE SHIRLEY A. VILLACARLOS

School Total

Table 2. Learner Records with Inconsistency/ies or Errors

No. of Records per Nature of Errors*
Grade
Section Name of Adviser With Incomplete Supporting
Level With Inconsistent/Error
Documents
9 AMBER MELVIC L. BUIZA
9 AMETHYST EVELYN L. ARENILLA
9 GARNET TIFFANY ANNE C. COLITA
9 OPAL MICHELLE S. DONGALLO
9 PEARL ZENDA C. AYING
9 TOPAZ HAZEL P. GARANGANAO
9 AQUAMARINE SHIRLEY A. VILLACARLOS

*Do not include Temporary Enrolled Learners as defined in Deped Order No. 3, s. 2018.
** % Accuracy refers to the percentage of correct/consistent records over total records examined or reviewed.

Table 3. For Transferred in/Moved in

Transfer of SF 10 (Formerly Form 137)
Without SF10**
Grade With SF 10
Section Name of Adviser (For Temporary En
Level
Received w/in Received beyond
From Private School
30 days 30 days
9 AMBER MELVIC L. BUIZA
9 AMETHYST EVELYN L. ARENILLA
9 GARNET TIFFANY ANNE C. COLITA
9 OPAL MICHELLE S. DONGALLO
9 PEARL ZENDA C. AYING
9 TOPAZ HAZEL P. GARANGANAO
9 AQUAMARINE SHIRLEY A. VILLACARLOS
Report Code: SFCR1 Annex 1a

***Do not include PEPT/PVT or ALS-A&E Certificate holders.

Table 4. For Transferred in/Moved In Learners Without SF 10 (formerly Form 137)

Grade
Section Name of Adviser LRN Name of Learner
Level
9 AMBER MELVIC L. BUIZA
9 AMETHYST EVELYN L. ARENILLA
9 GARNET TIFFANY ANNE C. COLITA
9 OPAL MICHELLE S. DONGALLO
9 PEARL ZENDA C. AYING
9 TOPAZ HAZEL P. GARANGANAO
9 AQUAMARINE SHIRLEY A. VILLACARLOS

Type of Checking Committee: / School Checking Committee (SCC)

Prepared by:

MARIA CHERILONA P. ESTOR THEA MAE C. ARENILLA TIFFANY ANNE C. COLITA

Chairman Vice Chairman Member
…………………………………………………………………………….. All fields below are solely for the use of the Division Checking Committee (D
Conforme:
TERESITA B. MONISIT
Principal II
 Report Code: SFCR1 Annex 1a

CHECKING REPORT

500042 DISTRICT: CATMON

amined/Reviewed* No. with Inconsistency or Incomplete

Supporting Documents % Accuracy**
Total Male Female Total

er Nature of Errors*
DCC Observation/Comment or Technical Assistance
ith Inconsistent/Error Total Provided
Lacking PSA Birth Certificate & ICT Coord. gave assistance
wrong bdate at LIS

(Formerly Form 137)

Without SF10**
(For Temporary Enrolled) DCC Observation/Comment or Technical Assistance
Provided
From Public
School/SUC/LUC
 Report Code: SFCR1 Annex 1a

Name of Originating School School ID Division/Region

cking Committee (SCC) Division Checking Committee (DCC)

TIFFANY ANNE C. COLITA CHARLENE A. DUMDUMAYA MICHELLE S. DONGALLO

Member Member Member
of the Division Checking Committee (DCC)……………………………………………………………………………..

Date Completed (School Level)

Report Code: SFCR1 Annex 1a

SCHOOL FORMS CHECKING REPORT

SCHOOL NAME: CATMON INTEGRATED SCHOOL SCHOOL ID:

Table 1. Learner Records Examined/Reviewed

Grade No. of Examined/Reviewed*

Section Name of Adviser Date Checked
Level
Male Female
7 AMBER FATIMA B. PONTILLAS
7 AMETHYST JANE S. BUTON
7 AQUAMARINE JENNIFER C. RUIZ
7 GARNET GECELIE M. MUELA
SORARY JEAN V.
7 OPAL
ARGONCILLO

School Total

Table 2. Learner Records with Inconsistency/ies or Errors

No. of Records per Nature of Errors*
Grade
Section Name of Adviser With Incomplete Supporting
Level With Inconsistent/Error
Documents
7 AMBER FATIMA B. PONTILLAS
7 AMETHYST JANE S. BUTON
7 AQUAMARINE JENNIFER C. RUIZ
7 GARNET GECELIE M. MUELA
SORARY JEAN V.
7 OPAL
ARGONCILLO

*Do not include Temporary Enrolled Learners as defined in Deped Order No. 3, s. 2018.
** % Accuracy refers to the percentage of correct/consistent records over total records examined or reviewed.

Table 3. For Transferred in/Moved in

Transfer of SF 10 (Formerly Form 137)
Without SF10**
Grade With SF 10
Section Name of Adviser (For Temporary En
Level
Received w/in Received beyond
From Private School
30 days 30 days
7 AMBER FATIMA B. PONTILLAS
7 AMETHYST JANE S. BUTON
7 AQUAMARINE JENNIFER C. RUIZ
7 GARNET GECELIE M. MUELA
SORARY JEAN V.
7 OPAL
ARGONCILLO
Report Code: SFCR1 Annex 1a

***Do not include PEPT/PVT or ALS-A&E Certificate holders.

Table 4. For Transferred in/Moved In Learners Without SF 10 (formerly Form 137)

Grade
Section Name of Adviser LRN Name of Learner
Level
7 AMBER FATIMA B. PONTILLAS
7 AMETHYST JANE S. BUTON
7 AQUAMARINE JENNIFER C. RUIZ
7 GARNET GECELIE M. MUELA
SORARY JEAN V.
7 OPAL
ARGONCILLO

Type of Checking Committee: / School Checking Committee (SCC)

Prepared by:

MARIA CHERILONA P. ESTOR THEA MAE C. ARENILLA JANE S. BUTON

Chairman Vice Chairman Member
…………………………………………………………………………….. All fields below are solely for the use of the Division Checking Committee (D
Conforme:
TERESITA B. MONISIT
Principal II
 Report Code: SFCR1 Annex 1a

OL FORMS CHECKING REPORT

500042 DISTRICT: CATMON

No. of Examined/Reviewed* No. with Inconsistency or Incomplete

Supporting Documents % Accuracy**
Total Male Female Total

Records per Nature of Errors*

DCC Observation/Comment or Technical Assistance
With Inconsistent/Error Total Provided
Lacking PSA Birth Certificate & ICT Coord. gave assistance
wrong bdate at LIS

r of SF 10 (Formerly Form 137)

Without SF10**
(For Temporary Enrolled) DCC Observation/Comment or Technical Assistance
Provided
From Public
School/SUC/LUC
 Report Code: SFCR1 Annex 1a

Name of Originating School School ID Division/Region

chool Checking Committee (SCC) Division Checking Committee (DCC)

JANE S. BUTON GALILEO ER-NAR B. MONISIT III MOISES B. SUCALIT

Member Member Member
ly for the use of the Division Checking Committee (DCC)……………………………………………………………………………..

Date Completed (School Level)

Report Code: SFCR1 Annex 1a

SCHOOL FORMS CHECKING REPORT

SCHOOL NAME: CATMON INTEGRATED SCHOOL SCHOOL ID:

Table 1. Learner Records Examined/Reviewed

Grade No. of Examined/Reviewed*

Section Name of Adviser Date Checked
Level
Male Female
8 AMBER NERLIE C. PELIGRINO
8 AMETHYST JEANETTE JOIE C. ALIMIN
8 AQUAMARINE JANET P. MONISIT
MATISSA MAE L. DE LA
8 GARNET
CERNA
8 OPAL MARIA VIRLY R. PAULIN
8 PEARL JOEDEL B. GARCIA
JEREBETH ELLAINE G.
8 TOPAZ
CANDOLITA

School Total

Table 2. Learner Records with Inconsistency/ies or Errors

No. of Records per Nature of Errors*
Grade
Section Name of Adviser With Incomplete Supporting
Level With Inconsistent/Error
Documents
8 AMBER NERLIE C. PELIGRINO
8 AMETHYST JEANETTE JOIE C. ALIMIN
8 AQUAMARINE JANET P. MONISIT
MATISSA MAE L. DE LA
8 GARNET
CERNA
8 OPAL MARIA VIRLY R. PAULIN
8 PEARL JOEDEL B. GARCIA
JEREBETH ELLAINE G.
8 TOPAZ
CANDOLITA

*Do not include Temporary Enrolled Learners as defined in Deped Order No. 3, s. 2018.
** % Accuracy refers to the percentage of correct/consistent records over total records examined or reviewed.

Table 3. For Transferred in/Moved in

Transfer of SF 10 (Formerly Form 137)
Without SF10**
Grade With SF 10
Section Name of Adviser (For Temporary En
Level
Received w/in Received beyond
From Private School
30 days 30 days
8 AMBER NERLIE C. PELIGRINO
8 AMETHYST JEANETTE JOIE C. ALIMIN
8 AQUAMARINE JANET P. MONISIT
MATISSA MAE L. DE LA
8 GARNET
CERNA
8 OPAL MARIA VIRLY R. PAULIN
8 PEARL JOEDEL B. GARCIA
Report Code: SFCR1 Annex 1a

JEREBETH ELLAINE G.
8 TOPAZ
CANDOLITA

***Do not include PEPT/PVT or ALS-A&E Certificate holders.

Table 4. For Transferred in/Moved In Learners Without SF 10 (formerly Form 137)

Grade
Section Name of Adviser LRN Name of Learner
Level
8 AMBER NERLIE C. PELIGRINO
8 AMETHYST JEANETTE JOIE C. ALIMIN
8 AQUAMARINE JANET P. MONISIT
MATISSA MAE L. DE LA
8 GARNET
CERNA
8 OPAL MARIA VIRLY R. PAULIN
8 PEARL JOEDEL B. GARCIA
JEREBETH ELLAINE G.
8 TOPAZ
CANDOLITA

Type of Checking Committee: / School Checking Committee (SCC)

Prepared by:

MARIA CHERILONA P. ESTOR THEA MAE C. ARENILLA MARIA VIRLY R. PAULIN

Chairman Vice Chairman Member
…………………………………………………………………………….. All fields below are solely for the use of the Division Checking Committee (D
Conforme:
TERESITA B. MONISIT
Principal II
 Report Code: SFCR1 Annex 1a

OL FORMS CHECKING REPORT

500042 DISTRICT: CATMON

No. of Examined/Reviewed* No. with Inconsistency or Incomplete

Supporting Documents % Accuracy**
Total Male Female Total

Records per Nature of Errors*

DCC Observation/Comment or Technical Assistance
With Inconsistent/Error Total Provided
Lacking PSA Birth Certificate & ICT Coord. gave assistance
wrong bdate at LIS

r of SF 10 (Formerly Form 137)

Without SF10**
(For Temporary Enrolled) DCC Observation/Comment or Technical Assistance
Provided
From Public
School/SUC/LUC
 Report Code: SFCR1 Annex 1a

Name of Originating School School ID Division/Region

chool Checking Committee (SCC) Division Checking Committee (DCC)

MARIA VIRLY R. PAULIN

Member Member Member
ly for the use of the Division Checking Committee (DCC)……………………………………………………………………………..

Date Completed (School Level)