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Disbursement Voucher Form
Disbursement Voucher Form
EXPLANATION AMOUNT
Php 186.41
A. Certified: B. Certified:
Allotment obligated for the purpose as indicate above Fund Available
Supporting documents complete
Signature Signature
EXPLANATION AMOUNT
To: Cas advance payment for the expenses to be incurred in LAKBAY ARAL Php 10,400.00
to be held on July 27 to 29, 2012 in Ilocos Region as per suppoting papers
hereto attached in the amount of . . . . . . . . . . . . . . . . . .
Php 10,400.00
A. Certified: B. Certified:
Allotment obligated for the purpose as indicate above Fund Available
Supporting documents complete
Signature Signature
ACCOUNTING ENTRIES
Account P AMOUNT
Responsibility Accounts & Explanation Code R Debit
Center
TOTAL 89,645.55
1000607
September 14, 2019
Cash Disbursement
AMOUNT
Credit
89,645.55
89,645.55
MERLE R. BADEL
Municipal Accountant
DISBURSEMENT VOUCHER (DV)
Instructions
A. The DV shall be printed in one whole sheet of 10. Certified (Box A) - certification of the Head
8 1/2 x 11 size bond paper. This shall be prepared of Accounting Unit or his authorized
in three copies to be distributed as follows: representative as to obligation of allotment
for the purpose as indicated and
Original - Accounting Unit completeness of supporting documents.
Duplicate - Cash Unit
Triplicate - Payee The certifying officer shall affix his
signature, print his name, indicate his
B. The Accounting Unit shall stamp the date of position, and the date of his signing on the
receipt on the face of this form. spaces provided.
C. This form shall be accomplished in the 11. Certified (Box B) - certification by the
following manner: Treasurer of his Authorized Representative
1. DV No. - number assigned to the DV by the on the availability of fund.
Accounting Unit. It shall be nembered as
follows: 12. Approved for Payment (Boxed C) - approval
0000 00 0000 by the Agency Head of his Authorized
Representative on the payment covered
Serial number by the DV.
(one series for each year)
Month 13. Received Payment (Box D) - Acknowledgment
Year by the claimant or his duly authorized
2. Mode of Payment - put a check " " mark in representative for the receipt of the
the appropriate box opposite the mode of check/cash and the date of receipt. The
payment. claimant/payee shall affix his signature on
3. Payee - name of the payee of creditor. the spaces provided and shall indicate the
4. TIN/Employee No. - Tax Identification number and the date of the check, bank name
Number (TIN) of the claimant/Identification and number and date of OR/ other relevant
Number assigned by the agency to the documents issued to acknowledge the receipt
officer/employee. of payment.
5. Obligation Request No. - Number of the
obligation request supporting the DV 14. JEV No. and Date - Number and date of the
6. Address - address of the claimant Journal Entry Voucher.
7. Responsibility Center (Office/Unit/Project
and Code) - the office/unit/project and code
assigned to the cost center where the
disbursement shall be charged.
8. Explanation - brief description of the
disbursement.
9. Amount - amount of claim.
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