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Appendix 32

Fund Cluster :
BUREAU OF FIRE PROTECTION O1
Caraga Region Date :
DISBURSEMENT VOUCHER DV No. :
Mode of MDS Check Commercial Check ADA Others (Please specify)
Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee

Address
Responsibility
Particulars MFO/PAP Amount
Center

To Establishment of Petty Cash Fund for


Internet Subscription for three (3) months CY 2017
in the total amount of . . . . . . . . . . . . . . . . . . . . . . . . 3-02-01-0000 3,900.00

Amount Due 3,900.00


A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment


Cash available

Subject to Authority to Debit Account (when applicable)

Supp

Signature Signature

Printed
Printed Name
Name
OIC, Regional Accounting Office Regional Director
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :

Official Receipt No. & Date/Other Documents


Appendix 32
Fund Cluster :
BUREAU OF FIRE PROTECTION O1
Caraga Region Date :
DISBURSEMENT VOUCHER DV No. :
Mode of MDS Check Commercial Check ADA Others (Please specify)
Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee

Address
Responsibility
Particulars MFO/PAP Amount
Center

To Establishment of Petty Cash Fund for


preventive maintenance CY 2017 in the total
amount of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-02-01-0000 10,000.00

Amount Due 10,000.00


A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment


Cash available

Subject to Authority to Debit Account (when applicable)

Supp

Signature Signature

Printed SHIRLEY SAUSAL TELERON, CE, MGM


SFO1 Gloria A Tiu, BFP Printed Name
Name SSUPT (DSC) BFP
OIC, Regional Accounting Office Regional Director
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :

Official Receipt No. & Date/Other Documents


Appendix 32
Fund Cluster :
BUREAU OF FIRE PROTECTION O1
Caraga Region Date :
DISBURSEMENT VOUCHER DV No. :
Mode of MDS Check Commercial Check ADA Others (Please specify)
Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee

Address
Responsibility
Particulars MFO/PAP Amount
Center

To Establishment of Petty Cash Fund for


Internet Subscription for three (3) months CY 2017
in the total amount of . . . . . . . . . . . . . . . . . . . . . . . . 3-02-01-0000 3,900.00

Amount Due 3,900.00


A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment


Cash available

Subject to Authority to Debit Account (when applicable)

Supp

Signature Signature

Printed SHIRLEY SAUSAL TELERON, CE, MGM


SFO1 Gloria A Tiu, BFP Printed Name
Name SSUPT (DSC) BFP
OIC, Regional Accounting Office Regional Director
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :

Official Receipt No. & Date/Other Documents