Summary of Petty Cash Disbursements

For the period _________________

Barangay: ________________________ City/Municipality: ___________________

Barangay Treasurer: ________________ Province: __________________________

OR
Date PCV No. Payee Particulars Amount
No./Ref.

Certification:

I hereby certify that the foregoing is the complete list of all payments for the
Petty Cash for the period ___________________________. The original copies of all
paid Petty Cash Vouchers and supporting documents are hereto attached.

___________________________________
Barangay Treasurer/Petty Cash Custodian

__________________
Date