Appendix 65
Republic of the Philippines
Department of Education
Region III
Division of Mabalacat City
WASTE MATERIALS REPORT
Entity Name : Doña Asuncion Lee Integrated School Fund Cluster : ___________________
Place of Storage : Doña Asuncion Lee Integrated School Date : _________________________
ITEMS FOR DISPOSAL
Record of Sales
Item Quantity Unit Description Official Receipt
No. Date Amount
1 129 Pcs English
2 130 Pcs Math
3 130 Pcs Science
4 125 Pcs Filipino
5 130 Pcs ESP
6 125 Pcs AP
7 130 Pcs EPP
8 133 Pcs Music
9 130 Pcs Arts
10 130 Pcs PE
11 130 Pcs Health
12
TOTAL
Certified Correct : Disposal Approved :
__________________________________
Signature over Printed Name of Signature over Printed Name of Head of
Supply and/or Property Custodian Agency/Entity or his/her Authorized
Representative
CERTIFICATE OF INSPECTION
I hereby certify that the property enumerated above was disposed of as follows:
Item ________ Destroyed
Item ________ Sold at private sale
Item ________ Sold at public auction
Item ________ Transferred without cost to _______________________
Certified Correct: Witness to Disposal:
Signature over Printed Name of Signature over Printed
Inspection Officer Name of Witness