Annex A

Republic of the Philippines

Province of Iloilo

OBLIGATION REQUEST No.

Payee PLDT, INC.
Office
Address RAMON COJUANGCO BLDG., MAKATI AVE., MAKATI CITY, 1200
Responsibility
Account
Center Particulars F.P.P. Amount
Code

For payment of Telephone and Internet Bill of Php 2,333.40

Miagao Municipal Police Station for the month
of October 2019 as per supporting documents
hereto attached --------------------------

T O TAL Php 2,333.40

A.) Certified B.) Certified
Charges to appropriation/allotment Existence of available appropriation
necessary, lawful and under my
direct supervision

Supporting documents valid, proper and legal

Signature Signature

Printed Name Printed

Name
Position Chief of Police Position Municipal Budget Officer
Head, Requesting Office/Authorized Head, Budget Unit/Authorized
Representative Representative
Date Date