Republic of the Philippines Republic of the Philippines

Department of Justice Department of Justice

Bureau of Corrections Bureau of Corrections
LEYTE REGIONAL PRISON LEYTE REGIONAL PRISON
Abuyog, Leyte Abuyog, Leyte

CLEARANCE SLIP CLEARANCE SLIP

NAME OF NAME OF
REQUESTING PARTY: ________________________ REQUESTING PARTY: ________________________

PURPOSE: ___________________________________ PURPOSE: ___________________________________

____________________________________________ ____________________________________________

DESTINATION: ________________________________ DESTINATION: ________________________________

DATE/TIME: __________________________________ DATE/TIME: __________________________________

NAME & SIGNATURE OF REQUESTING PARTY: NAME & SIGNATURE OF REQUESTING PARTY:

____________________________________________ ____________________________________________
Noted: Noted:
JOSE P. ESTONILO JR. JOSE P. ESTONILO JR.
Chief, GSCU ____ Chief, GSCU ____

Approved by: Approved by:

P/SUPT. GERALDO I. ARO P/SUPT. GERALDO I. ARO

Penal Superintendent Penal Superintendent

Note: Subject to our existing Prison Rules and Regulations. Note: Subject to our existing Prison Rules and Regulations.

Republic of the Philippines Republic of the Philippines

Department of Justice Department of Justice
Bureau of Corrections Bureau of Corrections
LEYTE REGIONAL PRISON LEYTE REGIONAL PRISON
Abuyog, Leyte Abuyog, Leyte

CLEARANCE SLIP CLEARANCE SLIP

NAME OF NAME OF
REQUESTING PARTY: ________________________ REQUESTING PARTY: ________________________

PURPOSE: ___________________________________ PURPOSE: ___________________________________

____________________________________________ ____________________________________________

DESTINATION: ________________________________ DESTINATION: ________________________________

DATE/TIME: __________________________________ DATE/TIME: __________________________________

NAME & SIGNATURE OF REQUESTING PARTY: NAME & SIGNATURE OF REQUESTING PARTY:

____________________________________________ ____________________________________________
Noted: Noted:
JOSE P. ESTONILO JR. JOSE P. ESTONILO JR.
Chief, GSCU ____ Chief, GSCU ____

Approved by: Approved by:

P/SUPT. GERALDO I. ARO P/SUPT. GERALDO I. ARO

Penal Superintendent Penal Superintendent

Note: Subject to our existing Prison Rules and Regulations. Note: Subject to our existing Prison Rules and Regulations.