LIQUIDATION REPORT

Name Employee No. ___________ Date

Dept./Office

Purpose of Cash Advance:

The following are strictly required to be attached in this report:

►Original Copy of Official Receipts
►Copy of the Disbursement Voucher of the Cash Advanced
►Copy of the Approved Request-to-Travel Form (for Liquidation of Travel Expenses)

DIFFERENCE
AMOUNT OF
Amt To be Returned/
CASH ADVANCE
ACTUAL (Refundable)

A. Accommodations/Hotels Php Php Php -

B. Transportation:

1) Plane Fare Php c/o OP

2) Boat Fare

3) Bus Fare

4) Others-Transpo -

C. Meals/Snacks -

D. Incidentals -

E. Others (Please Specify)

TOTAL ===> Php Php - Php -

OR Number: Date :

Charge Acct:

Submitted by: Approved by:

Employee Unit Head

Name & Signature Name & Signature

FOR FINANCE DEPARTMENT USE

Received by : Date Received: Checked & Verified by: Approved by:

________________
Finance Office Accountant In-Charge Director, General Accounting
Name & Signature Name & Signature