Appendix 32

Republic of the Philippines Fund Cluster :

Department of Environment and Natural Resources
REGION IV - CALABARZON
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Iyam, Lucena City, Quezon Province

Date :
DISBURSEMENT VOUCHER DV No. :

Mode of MDS Check Commercial Check ADA Others (Please specify)

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee DIANNEE ANTONIETTEE L. ENRIQUEZ

Address Maharlika Highway, Brgy. Ibabang Iyam, Lucena City

Responsibility
Particulars MFO/PAP Amount
Center
To payment of Wages of Technical Staff (Job
Order) for the month of August 2018 amounting ₱15,000.00
to…

ATTACHMENTS:
1. Request & Approval (Certified True Copy)
2. Approved Job Order (Certifed True Copy)
3. Approved DTR
4. Travel Order / PENRO Special Order / Pass-Out
5. Accomplishment Report & Relevant Pictures

Amount Due ₱15,000.00

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

ALFREDO C. PALENCIA
PENR Officer

B. Accounting Entry:

Account Title UACS Code Debit Credit

See Attached Journal Voucher

C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable)
Supp
proper

Signature Signature

Printed Printed
Name JENNY ANNE S. MATIRA Name ALFREDO C. PALENCIA
ACCOUNTANT III PENR Officer
Position Position

Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account
ADA No. : Number:
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents