Annex 7

DISBURSEMENT VOUCHER
SK of Barangay: DV No.:
City/ Municipality: Date:
Province:
Payee:
Address:
TIN:
Particulars Amount

A. Certified as to availability B. Certified as to availability C. Certified as to necessity

of the budget or funds received of cash and completeness and validity, propriety, and legality
for specific purpose propriety of supporting of claim; and Approved for
documents payment:

_________________________ _________________________ _________________________

(Signature Over Printed Name) (Signature Over Printed Name) (Signature Over Printed Name)
Budget Monitoring Officer SK Treasurer SK Chairperson

Date: Date: Date:

D. Received Payment: Check No.:
Date:
Bank
Signature Over Printed Name of Payee/ Name:
Authorized Representative Bank
Branch:
OR No.:
Date Date: