Republic of the Philippines

DEPARTMENT OF ENVIRONMENT AND NATURAL RESOUCES

CENRO-TABANG

DISBURSEMENT VOUCHER
Mode of
Payment
Payee

No.

MDS Check
Comm. Check
ADA
JOCELYN L. SARMIENTO
TIN/Employee No.

Address

248 Brgy. Pulong Sampaloc,

Doa Remedios, Trinidad, Bulacan

Responsibility Center
Office/Unit/Project
Code
Amount

EXPLANATION
To payment for hiring of Forestry Extension
Officer for the month of June, 2012 in the amount of . .

TOTAL
Certified

Others
OR No.

Php10,000.00

Php10,000.00

Approved Payment

Cash Available
Subject to Authority to Debit Account
Supporting Documents Complete
Signature
Printed
Name
Position
C

MA. CECILIA H. ANTONIO

Accountant II
Head, Requesting Office/Authorized Representative

Received Payment

Signature : ________________________
Printed Name : JOCELYN L. SAMIENTO

Signature
Printed
Name
Position

ELIZARDO B. ALBERTO
PENRO
Agency Head/Authorized
Representative

Check No. ____________ Journal Entry Voucher

Date _________________
Bank Name ____________ No. :_______________
Date :

Republic of the Philippines

DEPARTMENT OF ENVIRONMENT AND NATURAL RESOUCES
CENRO-TABANG
Fund
No.

OBLIGATION REQUEST
Payee
Office
Address
Responsibility
Center

Date
JOCELYN L. SARMIENTO
Tabang, Guiguinto, Bulacan
248 Brgy. Pulong Sampaloc, Doa Remedios, Trinidad, Bulacan
Account
P.P.A.
Code
To obligate fund for hiring of Forestry Extension
Officer

P30,000.00

Total
A

Certified

Amount

P30,000.00

B
Charges to appropriation/allotment necessary,
lawful and under my direct supervision

Allotment available and obligated

for the purpose as indicated above

Supporting documents valid, proper and legal

Signature
Printed
Name
Position
Date

ROGER V. ENCARNACION
CENRO
Head, Requesting Office/Authorized Representative

Signature
Printed
Name
Position
Date

NELIA S. BLANCO
Bookkeeper
Head, Budget Unit/Authorized
Representative