Type (Form No.

) Annex 41
Page 1 of 2

REPORTS OF COLLECTIONS AND DEPOSITS

PIGCAWAYAN
LGU

Fund: Date: 8/22/2017

NAME: CRISTINE T. GOMOBAR Report No. _____________________

A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F# 51 7990752 7990752 Php 1,000.00
A.F# 51 7990759 7990759 Php 5,000.00

TOTAL Php 6,000.00

Name of Accountable Officer Report No.

B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.
 Annex 41
SEF Page 2 of 2
C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
Name of Beginning Balance Receipt Issued Ending Balance
Forms &Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos.
No. From To From To From To From To

AF51 1 7990752 7990752 1 7990752 7990752 0 SOLD SOLD

AF51 1 7990759 7990759 1 7990759 7990759 0 SOLD SOLD

D. SUMMARY OF COLLECTIONS AND REMITTANCES / DEPOSITS

List of Checks:
Check Number Drawee Bank Date Amount

Total
Beginning Balance P Php 6,000.00
Add: Collections
Cash Php 6,000.00
Check/s P

Total P Php 6,000.00

Less: Remittance/Deposit to Cashier/ Php 6,000.00
Treasurer/Depository Bank
Balance P Php -
5

CERTIFICATION: VERIFICATION AND ACKNOWLEDGMENT:

I hereby certify that the foregoing report of collections I hereby certify that the foregoing report of collections
and deposits, and accountability for accountable forms has been verified and acknowledge receipt of ______
is true and correct. Php 6,000.00

CRISTINE T. GOMOBAR 8/22/2017 JAIME B. AQUINDE 8/22/2017

Name and Signature Date ACTING MUNICIPAL TREASURER Date
Accountable Officer
Type (Form No.) Annex 41
Page 1 of 2

REPORTS OF COLLECTIONS AND DEPOSITS

PIGCAWAYAN
LGU

Fund: TRUST FUND Date:10/09/2014

NAME: EXCELINO F. BUENO,JR. Report No. _____________________

A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F. 51 6206701C 6206701C Php 15,000.00

note: solicitation for the Mutya ng

Pigcawayan,2014

TOTAL Php 15,000.00

Name of Accountable Officer Report No.

B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.
 Annex 41
S.E.F. Page 2 of 2
C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
Name of Beginning Balance Receipt Issued Ending Balance
Forms & Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos.
No. From To From To From To From To

AF 56 50 0731401C 0731450C 4 0731401C 0731404C 46 0731405C 0731450C

D. SUMMARY OF COLLECTIONS AND REMITTANCES / DEPOSITS

List of Checks:
Check Number Drawee Bank Date Amount

Total
Beginning Balance P Php -
Add: Collections
Cash Php 6,439.32
Check/s P

Total P Php 6,439.32

Less: Remittance/Deposit to Cashier/ Php 6,439.32
Treasurer/Depository Bank
Balance P Php -

CERTIFICATION: VERIFICATION AND ACKNOWLEDGMENT:

I hereby certify that the foregoing report of collections I hereby certify that the foregoing report of collections
and deposits, and accountability for accountable forms has been verified and acknowledge receipt of ______
is true and correct. Php 6,439.32

EXCELINO F. BUENO, JR. 8/29/2014 ARNELINDA B. PALMA 8/29/2014

Name and Signature Date MUNICIPAL TREASURER Date
Accountable Officer
 REPORTS OF COLLECTIONS AND DEPOSITS
PIGCAWAYAN
LGU

Fund: SEF Date:08/29/2014

NAME: EXCELINO F. BUENO,JR. Report No. _____________________

A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F. 56 0731401C 0731404C Php 6,439.32

TOTAL Php 6,439.32

Name of Accountable Officer Report No.

B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.
 Annex 41
Page 2 of 2
C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
Name of Beginning Balance Receipt Issued Ending Balance
Forms & Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos.
No. From To From To From To From To

A.F. 56 35 0545766C 0545800C 1 0545766C 0545766C 34 0545767C 0545800C

D. SUMMARY OF COLLECTIONS AND REMITTANCES / DEPOSITS

List of Checks:
Check Number Drawee Bank Date Amount

Total
Beginning Balance P
Add: Collections
Cash PHP 11101.79
Check/s P 11,101.79

Total P 11,101.79
Less: Remittance/Deposit to Cashier/ 11,101.79
Treasurer/Depository Bank
Balance P Php -

CERTIFICATION: VERIFICATION AND ACKNOWLEDGMENT:

I hereby certify that the foregoing report of collections I hereby certify that the foregoing report of collections
and deposits, and accountability for accountable forms has been verified and acknowledge receipt of ______
is true and correct. 11,101.79

LAURO P. BALOFINOS JAIME B. AQUINDE

Name and Signature Date Asst. Municipal Treasurer Date
Accountable Officer In-Charge of Office

NOTE: 0R# 5062959 - Solicitation for 59th Foundation Anniversary of Pigcawayan

OR# 5062960 - Cash Advance Refund
Type (Form No.) Annex 41
Page 1 of 2

REPORTS OF COLLECTIONS AND DEPOSITS

PIGCAWAYAN
LGU

Fund: Date:10/18/2012

NAME: LAURO P. BALOFINOS Report No. _____________________

A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F. 51 5062958 5062958 Php 7,905.60

TOTAL Php 7,905.60

Name of Accountable Officer Report No.

B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.

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 Annex 41
Page 2 of 2
C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
Name of Beginning Balance Receipt Issued Ending Balance
Forms & Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos.
No. From To From To From To From To

A.F. 51 1 4970799C 4970799C 1 4970799C 4970799C SOLD SOLD

D. SUMMARY OF COLLECTIONS AND REMITTANCES / DEPOSITS

List of Checks:
Check Number Drawee Bank Date Amount

Total
Beginning Balance P Php -
Add: Collections
Cash 304.05
Check/s P 304.05

Total P 304.05
Less: Remittance/Deposit to Cashier/ 304.05
Treasurer/Depository Bank
Balance P Php -
5

CERTIFICATION: VERIFICATION AND ACKNOWLEDGMENT:

I hereby certify that the foregoing report of collections I hereby certify that the foregoing report of collections
and deposits, and accountability for accountable forms has been verified and acknowledge receipt of ______
is true and correct. 304.05

LAURO P. BALOFINOS JAIME B. AQUINDE

Name and Signature Date Asst. Municipal Treasurer Date
Accountable Officer In-Charge of Office

babeslargonio
Type (Form No.) Annex 41
Page 1 of 2

REPORTS OF COLLECTIONS AND DEPOSITS

PIGCAWAYAN
LGU

Fund: Date:10/10/2012

NAME: LAURO P. BALOFINOS Report No. _____________________

A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F. 51 4970799C 4970799C Php 304.05

TOTAL Php 304.05

Name of Accountable Officer Report No.

B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.

babeslargonio
 Annex 41
Page 2 of 2
C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
Name of Beginning Balance Receipt Issued Ending Balance
Forms & Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos.
No. From To From To From To From To

A.F. 51 1 5062956 5062956 1 5062956 5062956 SOLD SOLD

D. SUMMARY OF COLLECTIONS AND REMITTANCES / DEPOSITS

List of Checks:
Check Number Drawee Bank Date Amount
0085531* BDO 10/15/2012 6,100.00

Total
Beginning Balance P Php -
Add: Collections
Cash
Check/s 6,100.00 P 6,100.00

Total P 6,100.00
Less: Remittance/Deposit to Cashier/ 6,100.00
Treasurer/Depository Bank
Balance P Php -
5

CERTIFICATION: VERIFICATION AND ACKNOWLEDGMENT:

I hereby certify that the foregoing report of collections I hereby certify that the foregoing report of collections
and deposits, and accountability for accountable forms has been verified and acknowledge receipt of ______
is true and correct. 6,100.00

LAURO P. BALOFINOS JAIME B. AQUINDE

Name and Signature Date Asst. Municipal Treasurer Date
Accountable Officer In-Charge of Office

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Type (Form No.) Annex 41
Page 1 of 2

REPORTS OF COLLECTIONS AND DEPOSITS

PIGCAWAYAN
LGU

Fund: Date:10/16/2012

NAME: LAURO P. BALOFINOS Report No. _____________________

A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F. 51 5062956 5062956 Php 6,100.00

TOTAL
Name of Accountable Officer Report No. Php 6,100.00

B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.

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