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ANNEX "A"

Republic of the Philippines


Province of Cagayan
PROVINCIAL GOVERNMENT OF CAGAYAN
Capitol Hills, Tuguegarao City

No.
OBLIGATION REQUEST
Peyee: BGEN. RODOLFO ALVARADO (Ret.)
Office: Provincial Administrator
Address: Tuguegarao City
Responsibility
Center PARTICULARS E.P.P. Code Amount

1031 Representation Expense 5-01-02-090 2,975.00

TOTAL 2,975.00
A. CERTIFIED: B.

Charges to appropriation allotment necessary,


Existence of available appropiation.
and under my direct supervision.

Supporting documents valid, proper and legal.

Signature: Signatu

Printed Name: BGEN. RODOLFO ALVARADO (Ret.) Printe RAYNALD RAUL B. RAMIREZ
Position: Provincial Administrator Positio OFFICER IN CHARGE
Agency Head/Authorized Representative Head, Budget Unit/Authorized Representative
Date: Date:
Republic of the Philippines
Province of Cagayan
PROVINCIAL GOVERNMENT OF CAGAYAN
Capitol Hills, Tuguegarao City

No.
DISBURSEMENT VOUCHER
Mode of
Payment:
TIN/Employee No.: Obligation Request No.:
Payee: BGEN. RODOLFO G. ALVARADO (Ret.)
Responsibility Center
Address: Tuguegarao City Office/Unit/Project: Code:
PA

To payment of her REPRESENTATION ALLOWANCE for the month of September


2018 amounting to ------------------------------------------------------------------------------------ 8,500.00

8,500.00
A. Certified: B. p
Allotment obligated for the purposes indicated above. Funds available

Supporting documents complete.

Signature:

Printed Name: JEANNA C. GARMA Date: Printed Name: MILA Q. MALLONGA


Position: Provincial Accountant Position: Acting Provincial Treasurer
Head, Accounting Unit/Authorized Representative Head,Treasury Unit/Authorized Representative
C. Approved for payment: D. Received payment:
Signature: Cheque No.: Bank Name:

Printed Name: BGEN. RODOLFO G. ALVARADO (Ret.) Date: Signature:


Printed Name: BGEN. RODOLFO G. ALVARADO (Ret.)
Printed Name:
Position: Provincial Administrator O.R./Other documents: T.E.V. No.
Agency Head/Authorized Representative
No.

Obligation Request No.:

lity Center
Code:

8,500.00

8,500.00

LONGA Date:
Treasurer
ed Representative

Date:
T.E.V. No. Date:

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