Republic of the Philippines

LOCAL GOVERNMENT UNIT OF OZAMIZ CITY

Ozamiz City

NO.
OBLIGATION REQUEST
Payee

Office

Address Barangay Bagakay, Ozamiz City

Responsibility Particular
F. P. P. Account Code Amount
Center

To City’s Counterpart for the P. 100,000.00

improvement of Muti-purpose Hall of
Brangay Bagakay, Ozamiz City in the One Hundred
amount of……………….. Thousand Pesos

Total P. 100,000.00

A Certified B Certified

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

Supporting documents valid, proper and

legal.

Signature Signature
Printed Printed
Name Name

Position Head, Requesting Officer/Authorized Representative Position Head, Requesting Officer/Authorized Representative

Date Date