COA Central Office Clearance

COA clearance form for central office

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HUMAN RESOURCE MANAGEMENT OFFICE

COA CENTRAL OFFICE CLEARANCE
I

APPLICATION
Date of Application

TO:

THE COMMISSION ON AUDIT
I hereby apply for clearance from money, property and other accountabilities for:
Purpose: ____________________________________
Effectivity/Inclusive Period: ____________

Office of Assignment/Position: ___________________________________
II

______________________________________
Name and signature of applicant

CLEARANCE FROM OFFICE OF ASSIGNMENT
I hereby certify that this applicant is cleared of accountabilities in this Office.

_______________________________
Head of Office
III RESULTS OF VERIFICATION OF ACCOUNTABILITIES/PENDING ADMINISTRTIVE CASE
A. ACCOUNTABILITIES:
Cleared Not Cleared
Remarks
1. Administration Sector
a. Records Management Services, General Services Office
b. Procurement, Property & Supply Management Services,
General Services Office
c. Personnel Welfare & Assistance, HRMO
2. Commission Central Library
a. Legal Office Library
b. Library Services (Stationed at PIDS)
3. Planning, Finance & Management Sector
a. Financial Reporting Services, Accounting Office
b. Transaction, Processing & Billing Services, Accounting Office
c. Payroll & Remittance Services, Accounting Office
4. Professional and Institutional Development Sector
a. Scholarship Services
5. Other Financial Institutions
a. PhilGASEA
b. COA Multi-Purpose Cooperative (formerly COA Credit Union)
c. SLAGA
d. CREMC
B. PENDING ADMINISTRATIVE CASE:
a. Internal Affairs Office, Office of the Chairperson
with pending administrative case
with ongoing investigation (no formal charge yet)
This certifies that the Leave Administration and Retirement Services verified the accountability(ies) of the applicant with the offices/financial
institutions indicated above, through Accountability Verification Sheets duly signed by their authorized officials and accordingly indicated
results of said verification in the appropriate spaces/provided under Box III.

_________________________________
Service Chief
Leave Administration and Retirement Services

IV C E R T I F I C A T I O N
A
This certifies that the above-named
Employee is cleared from money and other
accountabilities from the offices/Units
indicated above and that he/she has no
record of any pending Administrative Case
involving any act or omission constituting a
groung for disciplinary acton under the Civil
Service Laws, Rules and Regulations or any
of the offenses defined and penalized under
R.A. No. 3019, as amended (Anti-Graft and
Corrupt Practice Act) and the provisions of
the Revised Penal Code on Bribery and that
this application is hereby:

APPROVED FOR THE
COMMISSION:
______________________
Director IV
Date of Signing: ___________

B

C
This certifies that the above-mentioned
Employee has:

This certifies that the above-mentioned
employee has/is:

Remaining uncleared accountabilities;

Remaining uncleared accountabilities
as co-maker as indicated above.

Has a record of pending Administrative
Case

Subject of an on-going investigation

as indicated above, by reason of which
this application for COA Central Office
Clearance is hereby:
DISAPPROVED FOR THE
COMMISSION:

_________________________
Director IV
Date of Signing: ____________

_________________________
Director IV
Date of Signing: ____________