Republic of the Philippines

Department of Education DIVISION OF PAMPANGA

City of San Fernando (Pampanga)

OBLIGATION SLIP
Payee/Ofice: Address:

DOLORES P. LABANDARIA
PARALAYUNAN E/S MABALACAT NORTH DISTRICT

No: Date: Responsibilty Center F/P.P.A: Account Code Amount

Particulars

Representing cash advance for payment of the following expenses in the total amount of . . . . . . . . . . . . . . . . (May to July 2011)
1 2 3 4 5

6,200.00

Electric Bills Traveling Allowance Office Supplies Medicine Seminar

A Certified:

Requested by:
Charges to appropriation/allotment necessary, lawful and under my direct supervision.

B Certified:

P Funds Available

6,200.00

Appropriation/Allotment available and obligated for the purpose as indicated above

Signature: Printed Name: Position: Signature: Printed Name: Position: Signature: Printed Name: Position: Date:

Signature: DOLORES P. LABANDARIA Head Teacher III Printed Name: PERLITA M. SORIANO Schools District Supervisor Position: Date: FELICIDAD D. MEDINA, Ph.D.
Assistant Schools Division Superintendent

LOLITA D. ALVARO Accountant II