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Form No.

FM-USeP-RSC-04
Republic of the Philippines

University of Southeastern Philippines Issue Status 02


Iñigo St., Bo. Obrero, Davao City 8000 Revision No. 01
Telephone: (082) 227-8192
Website: www.usep.edu.ph Date Effective 01 March 2018
Email: president@usep.edu.ph
Approved by President

STUDENT RECORDS CLAIM SLIP


(Please present this slip upon claiming the requested document/s)

Due Date: _________________


09/07/2020

Student’s Name: _______________________________________________________________


LOGRONIO RICHARD M.
(Last Name) (First Name) (Middle/Maiden Name)
Course & Year: ___________________________________________________________
BSCE

DOCUMENTS REQUESTED (Pls. check)

[ ] TOR [ ] HD [ ] Certification [ ] CAV [ ] Others: _______________

IMPORTANT NOTICE:

We require authorization letter and Valid I.D. for representative to


claim the requested document/s in student’s behalf.

Office of the University Registrar (OUR) Page 1 of 1

Form No. FM-USeP-RSC-04


Republic of the Philippines

University of Southeastern Philippines Issue Status 02


Iñigo St., Bo. Obrero, Davao City 8000 Revision No. 01
Telephone: (082) 227-8192
Website: www.usep.edu.ph Date Effective 01 March 2018
Email: president@usep.edu.ph
Approved by President

STUDENT RECORDS CLAIM SLIP


(Please present this slip upon claiming the requested document/s)

Due Date: _________________

Student’s Name: _______________________________________________________________


(Last Name) (First Name) (Middle/Maiden Name)
Course & Year: ___________________________________________________________

DOCUMENTS REQUESTED (Pls. check)

[ ] TOR [ ] HD [ ] Certification [ ] CAV [ ] Others: _______________

IMPORTANT NOTICE:
We require authorization letter and Valid I.D. for representative to
claim the requested document/s in student’s behalf.

Office of the University Registrar (OUR) Page 1 of 1

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