PETTY CASH REPLENISHMENT REPORT

CORDOVA,POLICE STATION
UNIT/OFFICE

PERIOD COVERED: FOR THE MONTH OF OCTOBER,2011

Report No
Sheet No.

DATE PCV No. PARTICULARS AMOUNT

15-Sep-11 001 Various expenses Php899.00
3-Oct-11 002 Various expenses Php923.00
17-Oct-11 003 Various expenses Php675.00
18-Oct-11 004 Various expenses Php914.00
20-Oct-11 005 Gasoline Php900.00
20-Oct-11 006 Various expenses Php948.00
23-Oct-11 007 Various expenses Php774.00
24-Oct-11 008 Various expenses Php900.00
24-Oct-11 009 Gasoline, Meals Php919.00
27-Oct-11 010 Gasoline Php1,000.00
28-Oct-11 011 Meals, Materials Php755.00
27-Oct-11 012 Gasoline Php500.00
29-Oct-11 013 Various expenses Php550.00
30-Oct-11 014 Cell Card & Eload Php550.00
31-Oct-11 015 Mineral Water, Tarpulin printing Php425.00
1-Nov-11 016 Gasoline Php1,000.00
3-Nov-11 017 Various expenses Php1,000.00
5-Nov-11 018 Gasoline Php1,000.00
5-Nov-11 019 Kitchen ware Php893.00
5-Nov-11 020 Reimbursement Php800.00
6-Nov-11 021 Cell Card & Eload Php750.00
8-Nov-11 022 Cell Card & Eload Php750.00
8-Nov-11 023 Fares & Fee Php278.00
9-Nov-11 024 1/2 sack rice Php975.00
9-Nov-11 025 Various expenses Php905.48
10-Nov-11 026 Fares & Fee, Gasul Php988.00
11-Nov-11 027 Gasoline & Representation Php800.00
16-Nov-11 028 Various expenses Php824.00
17-Nov-11 029 Various expenses Php1,455.00
20-Nov-11 030 Gasoline Php1,000.00
21-Nov-11 031 Various expenses Php149.52
25-Nov-11 032 Various expenses Php1,800.00

TOTAL AMOUNT Php27,000.00

CERTIFICATION

I hereby certify to the correctness of the above informatinon.

PO1 MARY ANN D. CARDOSA

Sub Petty Cash Custodian
11/22/2011
DATE
27,000.00
-
Petty Cash Custodian: Pssg ELEPHELEHU A BEBE Chief of Police: PLT WARLITO C TOÑACAO

SAMBOAN POLICE STATION-FINANCE DEPARTMENT

Department/Agency:
Sub-Office/ District/ Division: SAMBOAN POLICE STATION
Municipality SAMBOAN,CEBU
BREAKDOWN OF PAYMENTS
PETTYCASH FUND MAINTENANCE AND OTHER OPERATING EXPENSES
PCV No.
(104) Travelling Office Supplies
PARTICULARS
Expenses Expenses Gasoline, Oil &Other Supplies Rents
Date Balance
Receipts Payments Local Lubricants Expenses
(751) (755) Expenses
(+) (-) (761) (765) (782)
021 Cash Amount Received Balance #REF!
022 Food Supplies Expenses Php10,675 #REF!
6-Nov-11 023 Other Supplies Expenses Php750.00 #REF! 750.00
8-Nov-11 024 Fuel Expenses Php750.00 #REF! 278.00 750.00
8-Nov-11 025 Other Supplies Expenses Php278.00 #REF!
9-Nov-11 026 Office Supplies Expenses Php975.00 #REF! 480.00 975.00
9-Nov-11 027 Office Supplies Expenses Php905.48 #REF! 213.00 100.00 95.48
10-Nov-11
11-Nov-11 028
029 Other
Other Supplies
Supplies Expenses
Expenses Php988.00
Php800.00 #REF!
#REF! 500.00 775.00
300.00
16-Nov-11 030 Office Supplies Expenses Php824.00 #REF! 824.00
17-Nov-11 031 Travel Expenses Php1,455.00 #REF! 1,455.00
20-Nov-11 032 Other Supplies Expenses Php1,000.00 #REF! 1,000.00
21-Nov-11 Fuel Expenses Php149.52 #REF! 149.52
25-Nov-11 Php1,800.00 1,800.00

TOTAL Php0.00 491.00 480.00

Php10,675 Php10,675.00 1,600.00 7,874.00 - #REF!

0
CERTIFIED CORRECT:Signature over Printed Name (Petty Cash Custodian)
 PETTY CASH VOUCHER No. : SAMPS- 13-11-001
PNP PRO 7
Agency Date : November 25, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted
Total amount Paid per
Official Receipt No.

MOOE RECEIVED FOR THE

MONTH OF NOVEMBER Php20,900.00
CY 2013

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
PI CARMECHAELO A LESOY Reimbursement Paid
Name of Requestor

Approved by:
PCSUPT DANILO SANTOS CONSTANTINO
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PCI JANETTE P RAFTER Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: November 25, 2013 Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-11-002
PNP PRO 7
Agency Date : November 4, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 761

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php3,000.00
Total amount Paid per Php3,000.00
Official Receipt No.

Payment for Gasoline (Diesel) Php3,000.00 13851

Php3,000.00
Amount Refunded/
Reimbursed Php3,000.00

A Requested by: C
Received Refund
PO1 Rowel C Gerodias Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO1 Rowel C Gerodias PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: 4-Nov-13 Date: 4-Nov-13
 PETTY CASH VOUCHER No. : SAMPS- 13-11-003
PNP PRO 7
Agency Date : November 5, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 782

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php2,600.00
Total amount Paid per Php2,600.00
Official Receipt No.

Payment for Rent Php2,600.00

Php2,600.00
Amount Refunded/
Reimbursed Php2,600.00

A Requested by: C
Received Refund
PO3 Sepjanrey E Roda Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO3 Sepjanrey E Roda PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: November 5, 2013 Date: November 5, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-11-004
PNP PRO 7
Agency Date : November 7, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 755

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php150.00
Total amount Paid per Php150.00
Official Receipt No.

Payment for Office Supplies Php150.00 4014

Php150.00
Amount Refunded/
Reimbursed Php150.00

A Requested by: C
Received Refund
PO2 Mary Ann D Cardosa Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO2 Mary Ann D Cardosa PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: 7-Nov-13 Date: 7-Nov-13
 PETTY CASH VOUCHER No. : SAMPS- 13-11-005
PNP PRO 7
Agency Date : November 7, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 755

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php700.00
Total amount Paid per Php700.00
Official Receipt No.

Payment for Office Supplies Php700.00 4012

Php700.00
Amount Refunded/
Reimbursed Php700.00

A Requested by: C
Received Refund
PO3 Leopoldo S Godinez Jr Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO2 Mary Ann D Cardosa PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: November 7, 2013 Date: November 7, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-11-006
PNP PRO 7
Agency Date : November 11, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 761

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php3,000.00
Total amount Paid per Php3,000.00
Official Receipt No.

Payment for Gasoline (Diesel) Php3,000.00 13857

Php3,000.00
Amount Refunded/
Reimbursed Php3,000.00

A Requested by: C
Received Refund
PO1 Sergeberth B Hiramis Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO1 Sergeberth B Hiramis PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: November 11, 2013 Date: November 11, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-11-007
PNP PRO 7
Agency Date : November 13, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 765

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php2,350.00
Total amount Paid per Php2,350.00
Official Receipt No.

Payment for Other Supplies Php2,350.00 575

Php2,350.00
Amount Refunded/
Reimbursed Php2,350.00

A Requested by: C
Received Refund
PO1 Ramon M Catubig Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO1 Ramon M Catubig PO2 Mary Ann D Cardosa

Signature over Printed Name of Payee Signature of Payee
Date: November 13, 2013 Date: November 13, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-11-008
PNP PRO 7
Agency Date : November 18, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 761

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php3,000.00
Total amount Paid per Php3,000.00
Official Receipt No.

Payment for Gasoline (Diesel) Php3,000.00 13866

Php3,000.00
Amount Refunded/
Reimbursed Php3,000.00

A Requested by: C
Received Refund
PO1 Rowel C Gerodias Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO1 Rowel C Gerodias PO2 Mary Ann D Cardosa

Signature over Printed Name of Payee Signature of Payee
Date: November 18, 2013 Date: November 18, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-11-009
PNP PRO 7
Agency Date : November 25, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 751

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php1,195.00
Total amount Paid per Php1,195.00
Official Receipt No.

Payment for General Services Php1,195.00 65686

Php1,195.00
Amount Refunded/
Reimbursed Php1,195.00

A Requested by: C
Received Refund
PO2 Mary Ann D Cardosa Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO2 Mary Ann D Cardosa PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: November 25, 2013 Date: November 25, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-11-010
PNP PRO 7
Agency Date : November 25, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 761

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php3,000.00
Total amount Paid per Php3,000.00
Official Receipt No.

Payment for Gasoline (Diesel) Php3,000.00 13873

Php3,000.00
Amount Refunded/
Reimbursed Php3,000.00

A Requested by: C
Received Refund
PO1 Sergeberth B Hiramis Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO1 Sergeberth B Hiramis PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: November 25, 2013 Date: November 25, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-11-011
PNP PRO 7
Agency Date : November 25, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 755

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php548.00
Total amount Paid per Php548.00
Official Receipt No.

Payment for Office Supplies Php548.00 WACT271873

41

Php548.00
Amount Refunded/
Reimbursed Php548.00

A Requested by: C
Received Refund
PO2 Mary Ann D Cardosa Reimbursement Paid
Name of Requestor

Approved by:
P1 CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO2 Mary Ann D Cardosa PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: November 25, 2013 Date: November 25, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-11-012
PNP PRO 7
Agency Date : November 25, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 755

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php220.00
Total amount Paid per Php220.00
Official Receipt No.

Payment for Office Supplies Php220.00 4637

Php220.00
Amount Refunded/
Reimbursed Php220.00

A Requested by: C
Received Refund
PO2 Mary Ann D Cardosa Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO2 Mary Ann D Cardosa PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: November 25, 2013 Date: November 25, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-11-013
PNP PRO 7
Agency Date : November 25, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 755

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php959.00
Total amount Paid per Php959.00
Official Receipt No.

Payment for Office Supplies Php959.00 367140

Php959.00
Amount Refunded/
Reimbursed Php959.00

A Requested by: C
Received Refund
PO2 Mary Ann D Cardosa Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO2 Mary Ann D Cardosa PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: November 25, 2013 Date: November 25, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-11-014
PNP PRO 7
Agency Date : November 26, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 755

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php200.00
Total amount Paid per Php200.00
Official Receipt No.

Payment for Office Supplies Php200.00 3620

Php200.00
Amount Refunded/
Reimbursed Php200.00

A Requested by: C
Received Refund
PO2 Mary Ann D Cardosa Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO2 Mary Ann D Cardosa PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: November 26, 2013 Date: November 26, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-10-015
PNP PRO 7
Agency Date : October 31, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION 841

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php100.00
Total amount Paid per Php100.00
Official Receipt No.

Payment for Repair Php100.00

Php100.00
Amount Refunded/
Reimbursed Php100.00

A Requested by: C
Received Refund
PO1 Elephelehu A Bebe Reimbursement Paid
Name of Requestor

Approved by:
PI CARMECHAELO A LESOY PO2 Mary Ann D Cardosa
Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
PO2 Mary Ann D Cardosa Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

PO1 Elephelehu A Bebe PO2 Mary Ann D Cardosa

Signarure over Printed Name of Payee Signature of Payee
Date: October 31, 2013 Date: October 31, 2013
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date:
 PETTY CASH VOUCHER No. : SAMPS- 13-03-002
PNP PRO 7
Agency Date : March 22, 2013
Payee/Office: PO2 MARY ANN D. CARDOSA Responsibility Code Center

Address: SAMBOAN POLICE STATION

I. To be filled up upon request II. To be filled up upon liquidation
Particulars Amount Total Amount Granted Php0.00
Total amount Paid per Php0.00
Official Receipt No.

Php0.00
Amount Refunded/
Reimbursed Php0.00

A Requested by: C
Received Refund
Reimbursement Paid
Name of Requestor

Approved by:

Immediate Supervisor Petty Cash Custodian

B Paid by: D
Liquidation Submitted:
Reimbursement Received by:
Petty Cash Custodian

Cash Received by:

Signarure over Printed Name of Payee Signature of Payee

Date: Date: