SOP Exhibits

Title:

Forms A to H - Certificate of Clearance

SOP Number : HR-PR04

COC Form A
(4 copies)

Republic of the Philippines
NATIONAL FOOD AUTHORITY
___________________________
(Office of origin)

CERTIFICATION

This is to certify that based on available records of this office Mr./Ms. _______________________,
(Name of employee)
_____________________ has no records of accountability as of __________________.
(Position/Designation) (Date of Certification)

This certification is issued in connection with Mr./Ms. ___________________________________ ‘s application for _______________________ clearance required for his/her ___________________
(indicate if provisional or terminal) (indicate the purpose)
effective ___________________.
(indicate date)

_______________________________________
Department Manager/Regional Manager/

Provincial Manager

(Approving Authority - Office of Origin)
(Signature over printed name)

Date of Certification: ________________

COC Form B
(4 copies)

Republic of the Philippines
NATIONAL FOOD AUTHORITY
General Services Department/
Regional Office _________/Provincial Office _________

CERTIFICATION

This is to certify that based on available records of this office Mr./Ms. _______________________,
(Name of applicant)
________________________ has no property accountabilities (PPE/small tangible items/
(Position/Designation)
telephone bills/Communication Equipment and etc. ) of this office as of ______________________.
(Date of Certification)

This certification is issued in connection with Mr./Ms. ___________________________________ ‘s application for _____________________ clearance required for his/her ____________________
(indicate if provisional or terminal) (indicate the purpose)
effective ___________________.
(indicate date)

SUPPLY OFFICER/RECORDS OFFICER:
_______________________
_______________________
_______________________

______________________________________

Department Manager, GSD/RAO/PAO
(Signature over printed name)

Date of Certification: ___________

Supporting Document: Certificate from SSID (COC FORM C)

COC Form C

(4 copies)

Republic of the Philippines
NATIONAL FOOD AUTHORITY
Security Services and Investigation Department/
Regional Office _______/Provincial Office_________

CERTIFICATION

This is to certify that based on available records of this office _________________________,
(Name of employee)
_____________________, has been cleared from/has not been issued firearms accountability as of
(Position/Designation/Office)
________________ per Property Acknowledgement Receipt No. ____________ dated ________.
(Date of Certification)

This certification is issued in connection with Mr./Ms. _____________________________ ‘s application for ______________________ clearance required for his/her ___________________
(indicate if provisional or terminal) (indicate the purpose)
effective ___________________.
(indicate date)

ARMORER/SUPPLY OFFICER/PROPERTY CUSTODIAN:

_________________________
(Signature over printed name)

___________________________

Department Manager, SSID/
Regional/Provincial Manager
(Signature over printed name)

Date of Certification: __________

COC Form D

(4 copies)

Republic of the Philippines
NATIONAL FOOD AUTHORITY
Accounting Services Department
Regional Office _______/Provincial Office_________

CERTIFICATION

This is to certify that based on available records of this office _________________________,
(Name of employee)

_____________________________, has no money accountability (e.g.cash advances, unliquidated
(Position/Designation/Office)

TEVs, loans from NFA, COA disallowances and other receivables with NFA as of __________________.
(Date of Certification)

This certification is issued in connection with Mr./Ms. _____________________________ ‘s

application for ______________________ clearance required for his/her ___________________
(indicate if provisional or terminal) (indicate the purpose)

effective ___________________.
(indicate date)

____________________________
Department Manager, ASD/
Regional Accountant/Sr. Accounting Specialist
(Signature over printed name)

Date of Certification: __________

Supporting Documents:

Approved Certifications from: GSD; SSID; IASD; HRMD; and Provident Fund/MSMPC/NFA-MPC/NFAEA
Statement of Money Accountabilities (Exhibit 6)
Statement of Money Accountabilities Per Regional/Provincial Office Books (Exhibit 6.1)
Latest Service Record
Authority to Deduct (Exhibit 2)
If Terminal Clearance, computation of TLB

COC Form E

(4 copies)

Republic of the Philippines
NATIONAL FOOD AUTHORITY
Internal Audit Services Department

CERTIFICATION

This is to certify that based on available records of this office Mr./Ms. __________________
(Name of employee)
______________________, ____________________________ has no stock (grains and empty
(Position/Designation) (Office/Place of Assignment)

sacks) Accountabilities as of _________________________.
(Date of Cut-off)

This certification is issued upon the request of Ms./Mr. _______________________________
(Name of Requesting Official & Designation)
of _______________________, per fax message ______________________ as reference for the
(Office Address)
processing of Mr./Ms. _________________’s application for __________________ clearance
(Name of employee) (indicate if provisional or terminal)

required for his/her _______________________ effective ___________________.
(indicate the purpose of clearance) (indicate date)

____________________________

Department Manager, IASD
(Signature over printed name)
Date of Certification: __________

Supporting Document: Service Record

COC Form F

(4 copies)

Republic of the Philippines
NATIONAL FOOD AUTHORITY
Legal Affairs Department

CERTIFICATION

This is to certify that per available records, there is no pending administrative, and/or criminal/civil case filed by NFA against _______________________________________________,
(Name of employee)
_________________________________ and he/she is not a subject of a formal investigation
(Position/Designation/Office)

(criminal/civil or administrative).

This certification is issued in connection with Mr./Ms. _____________________________ ‘s
(applicant/requesting department/office)for

(check the purpose below):

[ ] application for vacation/sick leave with or without pay in excess of 30 calendar days
[ ] loans, please specify ___________________________________________
[ ] travel abroad (official/personal purpose)
[ ] retirement/resignation
[ ] designation/assignment/re-assignment as Warehouse supervisor
[ ] others, please specify ______________________________________

Valid for six _____ months from date of issuance.

Issued this _________ day of _____________________, ____ at Quezon City, Philippines.

____________________________
Department Manager, LAD
(Signature over printed name)

Date of Certification: __________

COC Form G

(4 copies)

Republic of the Philippines
NATIONAL FOOD AUTHORITY
Human Resource Management Department/
Regional Office _________/Provincial Office _________

CERTIFICATION

This is to certify that based on available records of this office _______________________,
(Name of employee)
_________________________, has complied with all the requirements necessary for the
(Position/Designation/Office)

approval of his/her clearance.

This further certifies that the estimated terminal leave benefit payable by NFA to the above named employee for the ______ years of government service with basic monthly income of __________ is _____________________________(Php________)

This certification is issued in connection with Mr./Ms. _____________________________ ‘s application for ___________________ clearance required for his/her ____________________
(indicate if provisional or terminal) (indicate the purpose)
effective ___________________.
(indicate date)

______________________________________
Department Manager, HRMD/RAO/PAO
(Signature over printed name)

Date of Certifications: _____________

COC Form H (4 copies)

MANAGEMENT SERVICE MULTI-PURPOSE COOPERATIVE

Statement of Outstanding Loan Balance & Monthly Amortization

To: _____________________________________________
(Name of employee)

This is to inform you that based on available records of this office, you have the following unpaid loans with us as of _________________:
LOAN AMOUNT
___________________ ____________
___________________ ____________
___________________ ____________ ___________________ ____________
Total ____________

Please settle the above loans with our Cashier/Treasurer and attach the certified photocopy of the corresponding Official Receipt to facilitate issuance of your certification.

_________________________ Date: ____________________
Credit & Collection Committee /
Authorized Officer
(Signature over printed name)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certification

This is to certify that based on available records Mr./Ms.______________________
(Name of employee/Office) has no outstanding accounts with MSMPC.

This certification is issued in connection with Mr./Ms._____________________ ‘s application for __________________ clearance required for his/her __________
(indicate if provisional or terminal) (indicate the purpose)
effective ___________________.
(indicate date)

_____________________________________ Date: ___________ Credit & Collection Committee / Authorized Officer
(Signature over printed name)

NFA MULTI-PURPOSE COOPERATIVE

Statement of Outstanding Loan Balance & Monthly Amortization

To: : _____________________________________________
(Name of employee)

This is to inform you that based on available records of this office, you have the following unpaid loans with us as of _________________:
LOAN AMOUNT
___________________ ____________
___________________ ____________
___________________ ____________ ___________________ ____________
Total ____________

Please settle the above loans with our Cashier/Treasurer and attach the certified photocopy of the corresponding Official Receipt to facilitate issuance of your certification.

_________________________ Date: ____________________
Credit & Collection Committee /
Authorized Officer
(Signature over printed name)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certification

This is to certify that based on available records Mr./Ms.____________________
(Name of employee/Office)
has no outstanding accounts with NFA-MPC.

This certification is issued in connection with Mr./Ms. _________________ ‘s application for __________________ clearance required for his/her _______
(indicate if provisional or terminal) (indicate the purpose)
effective ___________________.
(indicate date)

__________________________ Date: _____________
Credit & Collection Committee / Authorized Officer
(Signature over printed name)

NFA – PROVIDENT FUND

Statement of Outstanding Loan Balance & Monthly Amortization

To: _____________________________________________
(Name of employee)

This is to inform you that based on available records of this office, you have the following unpaid loans with us as of _________________:
LOAN AMOUNT
___________________ ____________
___________________ ____________
___________________ ____________ ___________________ ____________
Total ____________

Please settle the above loans with our Cashier/Treasurer and attach the certified photocopy of the corresponding Official Receipt to facilitate issuance of your certification.

_________________________ Date: ____________________
Authorized Officer
(Signature over printed name)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certification

This is to certify that based on available records Mr./Ms._____________________
(Name of employee/Office)
has no outstanding accounts with Provident Fund.

This certification is issued in connection with Mr./Ms. ____________________ ‘s application for __________________ clearance required for his/her __________
(indicate if provisional or terminal) (indicate the purpose)
effective ___________________.
(indicate date)

_______________________________________ Date: ___________
Authorized Officer
(Signature over printed name)

NFA EMPLOYEES ASSOCIATION

Statement of Outstanding Loan Balance & Monthly Amortization

To: _____________________________________________
(Name of employee)

This is to inform you that based on available records of this office, you have the following unpaid loans with us as of _________________:
LOAN AMOUNT
___________________ ____________
___________________ ____________
___________________ ____________ ___________________ ____________
Total ____________

Please settle the above loans with our Cashier/Treasurer and attach the certified photocopy of the corresponding Official Receipt to facilitate issuance of your certification.

_________________________ Date: ____________________
Authorized Officer
(Signature over printed name)
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certification

This is to certify that based on available records Mr./Ms. ___________________
(Name of employee/Office)
has no outstanding accounts with NFA EA.

This certification is issued in connection with Mr./Ms.__________________ ‘s application for _________________ clearance required for his/her _______
(indicate if provisional or terminal) (indicate the purpose)
effective ___________________.
(indicate date)

_______________________________________ Date: ___________
Authorized Officer
(Signature over printed name)