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Republic of the Philippines PROVINCIAL GOVERNMENT OF BOHOL Tagbilaran City

No.

DISBURSEMENT VOUCHER
Mode of Payment Payee Address Tagbilaran City EXPLANATION AMOUNT Check Cash
TIN/Employee No.

Others
Obligation Request No.
Responsibility Center Code

SMART COMMUNICATIONS INC


Office/Unit/Project

To payment of cellphone bills at the office of BM Torrefranca for the period of March 18 to April 19, 2013 as pertinent papers attached in the amount of

P 6,808.99

Supporting Papers:
1. OBR 2. Billing 3. BIR witholding

A. Certified * Allotment obligated for the purpose as indicated above * Supporting documents complete
Signature Printed Name Position Date

B. Certified Funds Available


Signature Printed Name Date

JOSETH J. CELOCIA Provincial Accountant

EUSTAQUIO A. SOCORIN
OIC-Provincial Treasurer

Head, Accounting Unit/Authorized Representative C. Approved for Payment

Signature
Printed Name Position Date

Treasurer/Authorized Representative D. Received Payment Check No. Bank Name Date Signature Printed Name OR/Other Documents JEV No.

Position

HON. CONCEPCION O. LIM Provincial Vice Governor


Agency Head/Authorized Representative

Date

Date

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