Appendix 23

FAR No. 4
MONTHLY REPORT OF DISBURSEMENTS
For the month of ______, 20___
Department: ___________________________________________
Entity Name: ___________________________________________
Operating Unit: ________________________________________
Organization Code (UACS): ______________________________
Funding Source Code (as clustered): _______________________
(e.g. Old Fund Code: 101,102, 151)

CURRENT YEAR BUDGET PRIOR YEAR'S BUDGET TRUST LIABILITIES GRAND TOTAL

PARTICULARS PRIOR YEAR'S ACCOUNTS PAYABLE CURRENT YEAR'S ACCOUNTS PAYABLE SUB-TOTAL Remarks
Fin. Fin.
PS MOOE CO TOTAL Fin. Fin. TOTAL PS MOOE CO TOTAL PS MOOE CO TOTAL
Exp PS MOOE CO Sub-Total PS MOOE CO Sub-Total Exp
Exp Exp
1 2 3 4 5 6= (2+ 3+4+5) 7 8 9 10 11= (7+ 8+9+10) 12 13 14 15 16= (12+ 13+14+15) 17=(11+16) 18=(6+17) 19 20 21 22=(19+20+21) 23 24 25 26 27=(23+24+25+26) 28
Notice of Cash Allocation (NCA) e.g. Reasons
MDS Checks Issued for over or
Advice to Debit Account under spending
Working Fund (NCA issued to BTr) and the catch-up
Tax Remittance Advices Issued (TRA) plan
Cash Disbursement Ceiling (CDC)
Non-Cash Availment Authority (NCAA)
Others (CDT, BTr Docs Stamp, etc.)
TOTAL
FEBRUARY
Notice of Cash Allocation
MDS Checks Issued
Advice to Debit Account
Tax Remittance Advices Issued
Cash Disbursement Ceiling
Non-Cash Availment Authority
Others (CDT, Docs Stamp, etc.)
TOTAL
MARCH
73

Notice of Cash Allocation

MDS Checks Issued
Advice to Debit Account
Tax Remittance Advices Issued
Cash Disbursement Ceiling
Non-Cash Availment Authority
Others (CDT, Docs Stamp, etc.)
TOTAL
1ST QUARTER
Notice of Cash Allocation
MDS Checks Issued
Advice to Debit Account
Tax Remittance Advices Issued
Cash Disbursement Ceiling
Non-Cash Availment Authority
Others (CDT, Docs Stamp, etc.)

GRAND TOTAL
SUMMARY:
Previous Report (Feb) This month (March) As of Date Previous Report (Feb) This month (March) As of Date
Total Disbursement Authorities Received Total Disbursements Program
NCA Less: * Actual Disbursements
Working Fund (Over)/Under spending
TRA
CDC
NCAA
Others (CDT, BTr Docs Stamp, etc.)
Less: Notice of Transfer Allocations (NTA)* issued
Total Disbursements Authorities Available
Less: Lapsed NCA
Disbursements *
Balance of Disbursements Authorities as of to date
Notes: The use of NTA is discouraged
* Amounts should tally
Certified Correct: Approved By:

Agency Chief Accountant Head of Agency or Authorized Representative

Date: ____________________________ Date: ____________________________