Annex 19

SUPPLIES AND MATERIALS ACKNOWLEDGEMENT RECEIPT

Barangay: City/Municipality: SMAR No.:
Tel. No.: Province: Date:
Ref. Date
Quantity Unit Description Cost
No. Acquired

Received by: Issued by:

________________________ ________________________
Signature over Printed Name Signature over Printed Name
Recipient/User Barangay Treasurer

___________ ___________
Date Date

SUPPLIES AND MATERIALS ACKNOWLEDGEMENT RECEIPT

 Annex 19

INSTRUCTIONS

A. This shall be prepared by the Barangay Treasurer upon receipt of donated supplies and
materials. This form shall be accomplished as follows:

1. Barangay – name of the barangay

2. Tel. No. – telephone number of the barangay
3. City/Municipality – city/municipality where the barangay is located
4. Province – province of the barangay
5. SMAR No. – the SMAR shall be numbered as follows:
00 - 00 - 000

Serial number (one series for each year)

Month
Year

6. Date – Date of the SMAR

7. Quantity – number of units given to the employee or user of the supplies and
materials
8. Unit – Unit of measurement
9. Description – brief description or details of the items issued to the employee/user
10. Ref. No. – assigned property number of the property issued
11. Date Acquired – acquisition date of the property
12. Cost – cost/value of the property received

B. The SMAR shall be prepared in two copies and distributed as follows:

Original – Barangay Treasurer

2nd copy – Requesting person

C. The recipient who is accountable for the property or equipment shall sign in the
“received by” portion of the form and indicate the date of receipt.

D. The Barangay Treasurer shall sign in the Issued by portion and indicate the date.

E. The SMAR shall be renewed every three years or every time there is a change
custodianship/user of the property.