Appendix 32

Fund Cluster :
.
Date :
DISBURSEMENT VOUCHER DV No. :

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

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee ELEMENTARY SCHOOL

Address DONSOL WEST DISTRICT (CLUSTER 16)

Responsibility
Particulars MFO/PAP Amount
Center

To Payment of Cash Advance - ELEMENTARY P 11,108.00

School for the month of November to December 2021 as
per supporting papers hereto attached..

ACCOUNT# 0782-1245-01
Amount Due P 11,108.00
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

ELY M. CADAG JR.

Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit
Advances for Operating Expenses 1990101000 11,108.00
Cash, National Treasury, MDS 1010404000 11,108.00

C. Certified: D. Approved for Payment

x Cash available
x Subject to Authority to Debit Account (when applicable)
x Sup
proper

Signature Signature

Printed
Printed Name
Name PAUL ANDY D. DEBLOIS JOSE L. DONCILLO, CESO V
ACCOUNTANT III Schools Division Superintendent
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.

Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents

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