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DV No.

___________
DISBURSEMENT VOUCHER Date: ___________

Barangay 148 Zone 16 City/Municipality: Pasay City


Tel. No. ____________ Province: NCR
Payee/Office: Lilibeth Fulgar Employee No. ________ Fund
Address: Pasay City TIN No. ____________ General Fund

Particulars Amount

Liquidation of expenses for Barangay Assemly 12,000

Amount Due P
12,000

B
CA
Certified Certified Certified
Existence of available appropriation for Funds (Cash) Available As to validity, propriety and legality of
the changes/expenses indicated above claim.
Approved:
For payment
Signature: _______________ Signature: _______________
Printed Name: Alex Cascas Signature: _______________
Printed Name: Lilibeth Fulgar
Position: Chairman,Comm. On Position: Brgy. Treasurer Printed Name: Michelle Tumazar
Appropriation Position: Brgy. Chairman
Date: ______________
Date: ______________ Date: ______________

D
Received Payment:

Lilibeth Fulgar
____________________________ Check No. ________ Date: ________
Signature Over Printed Name Bank Name: Land Bank Pasay
Date: ___________ OR Number: ________Date: ________
DV No. ___________
DISBURSEMENT VOUCHER Date: ___________

Barangay 148 Zone 16 City/Municipality: Pasay City


Tel. No. ____________ Province: NCR
Payee/Office: Lilibeth Fulgar Employee No. ________ Fund
Address: Pasay City TIN No. ____________ General Fund

Particulars Amount

12,000
Liquidation of expenses for Barangay Assembly

Amount Due P
12,000

B
CA
Certified Certified Certified
Existence of available appropriation for Funds (Cash) Available As to validity, propriety and legality of
the changes/expenses indicated above claim.
Approved:
For payment
Signature: _______________ Signature: _______________
Printed Name: Alex Cascas Signature: _______________
Printed Name: Lilibeth Fulgar
Position: Chairman,Comm. On Position: Brgy. Treasurer Printed Name: Michelle Tumazar
Appropriation Position: Brgy. Chairman
Date: ______________
Date: ______________ Date: ______________

D
Received Payment:

Lilibeth Fulgar
____________________________ Check No. ________ Date: ________
Signature Over Printed Name Bank Name: Land Bank Pasay
Date: ___________ OR Number: ________Date: ________
DV No. ___________
DISBURSEMENT VOUCHER Date: ___________

Barangay 148 Zone 16 City/Municipality: Pasay City


Tel. No. ____________ Province: NCR
Payee/Office: Lilibeth Fulgar Employee No. ________ Fund
Address: Pasay City TIN No. ____________ General Fund

Particulars Amount

Reimbursement of Expenses of the Barangay Captain and 28,000


Barangay Treasurer for the month of January to July 2016. In the
amount of

28,000
Amount Due P

B
CA
Certified Certified Certified
Existence of available appropriation for Funds (Cash) Available As to validity, propriety and legality of
the changes/expenses indicated above claim.
Approved:
For payment
Signature: _______________ Signature: _______________
Printed Name: Alex Cascas Signature: _______________
Printed Name: Lilibeth Fulgar
Position: Chairman,Comm. On Position: Brgy. Treasurer Printed Name: Michelle Tumazar
Appropriation Position: Brgy. Chairman
Date: ______________
Date: ______________ Date: ______________

D
Received Payment:

Lilibeth Fulgar
____________________________ Check No. ________ Date: ________
Signature Over Printed Name Bank Name: Land Bank Pasay
Date: ___________ OR Number: ________Date: ________
DV No. ___________
DISBURSEMENT VOUCHER Date: ___________

Barangay 148 Zone 16 City/Municipality: Pasay City


Tel. No. ____________ Province: NCR
Payee/Office: Lilibeth Fulgar Employee No. ________ Fund
Address: Pasay City TIN No. ____________ General Fund

Particulars Amount

Reimbursement of Expenses of the Barangay Captain and 22,000


Barangay Treasurer for the month of August to December 2016.
In the amount of

22,000
Amount Due P

B
CA
Certified Certified Certified
Existence of available appropriation for Funds (Cash) Available As to validity, propriety and legality of
the changes/expenses indicated above claim.
Approved:
For payment
Signature: _______________ Signature: _______________
Printed Name: Alex Cascas Signature: _______________
Printed Name: Lilibeth Fulgar
Position: Chairman,Comm. On Position: Brgy. Treasurer Printed Name: Michelle Tumazar
Appropriation Position: Brgy. Chairman
Date: ______________
Date: ______________ Date: ______________

D
Received Payment:

Lilibeth Fulgar
____________________________ Check No. ________ Date: ________
Signature Over Printed Name Bank Name: Land Bank Pasay
Date: ___________ OR Number: ________Date: ________