LIQUIDATION REPORT

Department of Education Division of Nueva Ecija

No. Date: Responsibility Center Code:

PARTICULARS
TO LIQUIDATE CASH ADVCANCE ON THE DOWNLOADING OF MOOE FOR THE MONTH OF JUNE 2012 IN THE AMOUNT OF P 12,492.00 PLACE: SAN PABLO (BATA) ELEMENTARY SCHOOL, SAN PABLO (BATA) ALIAGA, NUEVA ECIJA

AMOUNT

P 12,492.00 ACTUAL AMOUNT SPENT TOTAL AMOUNT SPENT BALANCE OF PREVIOUS ALOBS No. CASH ADVANCE PER DV Per Check No. NO. DTD. AMOUNT OF CASH ALOBS No. ADVANCE PER DV NO. Per Check No. 8036400 DTD. AMOUNT REFUNDED PER OR NO. _____________DTD. ____________ AMOUNT TO BE REIMBURSED P 12,492.00

P 12, 492.00

A.

Certified: Correctness B. Certified: Purpose of C. Certified: Supporting of the above data. travel/cash advance duly documents complete and accomplished. proper.

CARMELITA S.CUDIA Claimant

Designation : School Principal I School: San Pablo (Bata) Elem. Sch.

LOURDES P. CACATIAN District Supervisor

MARAH MANAHAN PACSON Head, Accounting Unit

JEV No.: