REPORTS OF CHECKS ISSUED

Name of Office

Bank Name/Account No: Sheet No:

Check
DV No. Payee Nature of Payment Amount
Date No.

TOTAL

CERTIFICATION

I hereby certify that this Report of checks issued in one (1) sheet is full, true and correct statement of all checks issued by me in payments for obligations for the period stated
shown in the attached disbursement vouchers.

Prepared by: Noted by:

____________________________________________
Barangay Treasurer Punong Barangay

Verified by:

____________________________
COA Auditor
 REPORTS OF CHECKS ISSUED
BARANGAY _______, ___________, ILOILO
Name of Office

Bank Name/Account No: EXAMPLE:BARANGAY BENIGNO- 003/001 Sheet No:

Check
DV No. Payee Nature of Payment Amount
Date No.
DATE SANG
TRANSACTION SA NUMERO SNG CHECK PANGALAN SNG TREASURER NGA KNG
Cash advance for the payment of salary OF
VOUCHER SNG PAG NGA GN ISSUE SA NUMERO SNG VOUCHER DIIN NAKA CASH ADVANCE ANG
TUPAD WORKERS (_NUMBER OF_____ 39,500.00
CASH ADVANCE TREASURER NGA INOG SNG PAG CASH ADVANCE SWELDO (or any bonded person of the
WORKERS)
SNG SWELDO SNG CASH ADVANCE LGU
TAWO

TOTAL 39,500

CERTIFICATION

I hereby certify that this Report of checks issued in one (1) sheet is full, true and correct statement of all checks issued by me in payments for obligations for the period stated
shown in the attached disbursement vouchers. (DATE SA VOUCHER KG CHECK NUMBER-W/ AMOUNT)

Prepared by: Noted by:

____________________________________________
Barangay Treasurer Punong Barangay

Verified by:

____________________________
COA Auditor