Appendix 32

PHILIPPINE COAST GUARD Fund Cluster :

Entity Name
Date : 19 May 2020
DISBURSEMENT VOUCHER DV No. CGSS Duman-1119-002

Mode of MDS Check Commercial Check ADA Others (Please specify)

Payment
_________________
Payee PO1 Rudolph Alain C Benolirao PCG TIN/Employee No.: ORS/BURS No.:

Address
Brgy., Tangil, Dumanjug Cebu
Responsibility
Particulars MFO/PAP Amount
Center
To reimburse Mandatory bills of Coast Guard Sub Station
Dumanjug for the month of November 2019 amounting to
TWO THOUSAND FIVE HUNDRED FIFTY SIX PESOS ONLY
(P 2,556.00)
P 2,556.00

Amount Due P 2,556.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

LTJG ROLAND A MAGDADARO PCG

Station Commander, CGS Southern Cebu
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable) TWO THOUSAND FIVE HUNDRED FIFTY SIX PESOS ONLY
SupSupporting documents complete and amount claimed (P 2,556.00)
proper

Signature Signature
Printed Printed
Name LTJG JAYBEE C REJANO PCG Name RADM ROLANDO LIZOR N PUNZALAN PCG
Deputy Chief of Coast Guard Staff
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Date : Bank Name & Account
Check/
ADA No. :
Number:LBP/3956-0134-36
Date : Printed Name: PO1 Date
Signature : Rudolph Alain C Benolirao
PCG
Official Receipt No. & Date/Other Documents