Appendix 12

NOTICE OF OBLIGATION REQUEST AND STATUS ADJUSTMENT Serial No. : _________

_______________________________ Date : _____________
Entity Name Fund Cluster : ______

For: The Budget Officer:

Budget Division/Unit

Please adjust ORS No. ___________________dated ___________________

due to the following changes:

Responsibility Center to ___________________________

Particulars to ___________________________
MFO/PAP to ___________________________
Account Code to ___________________________
Amount to P ___________________________

Please adjust RAOD for excess/under obligation per attached

JEV No. ___________dated ____________.

A. B.
Prepared by: Approved by:

____________________________ _____________________________
Accounting Staff-in-Charge Chief Accountant/Head of Accounting
Division/Unit

C. D.
Certified Correct: Verified by:

_____________________________ ________________________________
Head of Requesting Office/ Head of Budget Division/Unit/
Authorized Representative Authorized Representative

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