ATTACHMENT 2 (AGENCY LETTERHEAD) LUST OF BONDED ACCOUNTABLE PUBLIC OFFICER/S “TYPE OF APPLICATION RROOTERRTORTA ‘AMOUNT waters (check” “the DESIGNATION | EFFECTIVEDATE 2 ia ae = BOND REMARKS Icorricen | °Proriate Column) | (eg Disbusing/ Risk No. ccovenace | ¢wiry/winour Coecting/ging ‘accountaatury | Bonn | premium | (203 | pevone cant trom | to yews) | AowantsreariveANO : ae CRIMINAL CASE ow | nenewar 4 ne 7 (ER Capen. NE) 7 Broy Tecasier Nea-ag VyeorREQUEST FOR APPLICATION FOR BONDING AND/OR CANCELLATION OF FIDELITY BOND OF ACCOUNTABLE PUBLIC OFFICER 1: WONTHLY INCOME (Salieatowances Business came and etka) —]T7-ESTMATED MONTHLY EXPENOES lo =a FDP 16. | decare thatthe answer tothe foregoing questions are true tothe best of my knowledge and belie. | fuly understand that any rmisrepcesentation made inthis application and supporing documents shall cause the fing of administrative/criminal case(s) against me. ‘Government Issued ID ID/Ucense/Passpor Number 5 Lhe DatePace of issue ‘SUBSCRIBED AND SWORN to before meitig___————_ afar exiting hier vay nsued Government ID asindcated above. Doe. No Page No. Book No. Series of(6) Public Funds (1) As Cotectng omer (@)As Diburaing Offer (@)A8 Signing Otons (4) investment Oncer (GS Investments) (0) Public Property () everres (per GAAM) (2) Property, Pint & Equipment et Book Vain) (6) Forms and other valuables (1) ternal Revenue Stamps (2) Postage and other Stamped Stock £2) Oil Receipt (4) Others Forms and valuables ‘TOTAL AMOUNT ‘31, THIS IS TO CERTIFY THAT, a8 Head of Agency of. ofthe answers tothe questions contained onthe face of this form and found them correct msofar | verified the tuthtuness. Cane ascertained and thatthe ‘applicant isa safe and conservative risk. Hence, the undersigned is recommending approval and authoring the request for ‘Aaplcaton for Bonding Co New ZI Renewal (1 cancetaton of Bond ofthe above accountable pub officer ER ‘This isto cert that | have carefully evaluated the request for ‘of Fidelity Bond ofthe abovermentioned accountable public office. Tr ap TT oe $$ Z JCANCELLATIONForm 3: Annex D. mzrnucor rm remurpmes —_faneavons BRBIERLg" Form REQUEST FOR APPLICATION FOR BONDING AND/OR CANCELLATION OF FIDELITY BOND OF ACCOUNTABLE PUBLIC OFFICER 445 - 322 505-00m 90 000 00 Have you ever boon found gully of criminal case before any court? Oe Dw ys ge ate coon oats newer tothe foregoing questions are true to the best of my knowledge and belie. | fully understand that ary misrepresentation made in this application and supporting documents shall cause the fling of administrativelcriminal case(®) ‘against me. ‘Government sued 1D : IN ‘BilconserPassport Number | MARY DaterPace of sue : Dame T=e Tes an ‘SUBSCRIBED AND SWORN to before me tis, aan exrbitng hier valid egued Government (Das nested above(a) Public Funds (1) As Cotecng Oftoet (2) As Disbursing Ofte (@) As Signing Offeer (4) Investment Officer (GS Investments) (®) Public Property (1) iveniones (per GAM) (2) Property, rant & Equipment (et Boot Vat) (c) Forms and other valuables (7) literal Revenue Stamps (2) Postage are other Stamped Stock (9) Offical Recelct (4) Otters Forms and valuables TOTAL AMOUNT 31, THIS IS TO CERTIFY THAT, as Head of Agency of | verified the truntuiness ‘ofthe answers tothe questions contained onthe face of tis form and found them correct insofar as can be ascertained and thatthe ‘applicant is a tate and conservative risk. Hence, the undersigned is recommending approval and authorizing the request for ‘Aplcation for Bonding Conew [Dy Renewal [1 cancetaion of Bond cot he above accountable pubic oer Ts ae OBE FITEDEY ETON "AMOUNT OF BOND RECOMMENDED pL UOUNT oF oon PREM PRYABLE | “This sto certly that | have carefully evaluated the request for ‘of Fidelity Bond ofthe above-mentioned accountable pubic officer. Tae Sgratie of BT OarBarangay Budget Preparation Form No. 1 IIL Expenditures Personal Services (PS) 5-01-02-100] Barangay Sta. cruz Gity/Municipality of Villaba Province of Leyte GENERAL FUND ‘Current Year Appropriation (CY 2021) Budget Yea PARTICULARS Account | income Past Year First Second (Proposed) Code | caamitca (Actual) Semester Semester Total FY 2022 tion 2020 (Actual) (Estimate) @) @) (3) (4) ®) 6) (ul (8) Il. Beginning Cash Balance I IL. Receipts Share on Real Property Tax 4-01-02-040] | R 26,091.15 10,632.19 5,367.81 16,000.00 15,000.0 Business Taxes & Licenses (Stores & Retailers) 4-01-03-030} oR : = 5,000.00 5,000.00 5,000.0 Internal Revenue Allotment (IRA) 4-01-06-010| 2,159,076.00] — 1,156,044.00] —1,156,19200] 2,312,236.00| _3,196,399.0 Inter-Local Transfer (Subsidy from LGUs) '4-61-02-020] NR 11,000.00 1,000.00 . 1,000.00 1,000.0 Clearance/ Certification Fees 40201-040/ R 5,650.00 9,500.00 500.00 10,000.00 10,000.01 Other Receipts 4-06-01-010| NR - - - TOTAL RECEIPTS 219181715 [117747619 | 116705981 | 234425600] 3257398. Honoraria 500,400.00) 501,296.52] 1,001,686.52] —1,160,320.00 Cash Gift 5-01-02-159] , 55,000.00 55,000.00 55,000.00 Year End Bonus 5-01-02-140] : Other Bonuses and Allowances 5-01-02-990] - = Total PS 939,113.00 [500,400.00 | 556,296.52 | _1,056,6652| 120550000 Maintenance & Other Operating Expenses (MOOE) Trav 5-0 17,560.00 10,230.00 50,000.00 30,000.00 5-07 2 30,000.00 50,000.00, Office Supplies and Materials Expense 5-02-03-010] 9,084.50 13,576.00 (43,576.00) - 20,000.00 Other Supplies Expensses 5-02-03-990] 2 - - 20,000.00 |Barangay Budget Preparation Fo Blectricity Expenses 5 = 720,000.00 20,000.00, 30,000.00, Auditing Services 2,000.00 2,000.00, 000.00 3,000.00 3,000.00 Other Professional Services ( BHW, BNS, BSPO ) 76,800.00 48,000.00 48,000.00 96,000.00] 129,600.00 Other Professional Services DCW, Bookkeeper 21,700.00 112,000.00 12,000.00] 24,000.00 27,600.00 Other Professional Services ( Lupon ) - - - - 118,000.00 Security Services 119,000.00 78,000.00 78,000.00 | 156,000.00] 156,000.00 Janitorial Services 7,500.00 4,000.00 4,000.00 8,000.00 8,000.00 Reforestration(Purchase of Planting materials ) 30,000.00 Repairs & Maint, - Bldg, & Other Structures u ‘Fidelity Bond Premiums 5-02-16-020} 3,028.50 - 5,000.00 5,000.00 Membership Dues & Contributions (LIGA Dues) _|5-02-99-060] 4,000.00 4,000.00 - 4,000.00 (Other MOOE ( Senior Citizen ) 5-02.99.999} 9,370.00 - 2344236| 23,442.36 (Other MOOE 5-02.99.990] 43,930.75, 12,000.00, 18,572.16 30,572.16 Total MOOE 313,973.75 | 18580600 | 26620852] 450,014.52 Capital Outlay ‘ Fumiture and Fixtures 1-07-05-030 49,985.00 LT. Equipment and Software 1-07-05-990} : Total Capital Outlay 49,585.00 ‘Special Purpose Appropriation (SPA) = 20% BDF 424,000.00 462,447.20] 462,447.20] 639,279.80 10% SK - 234423.60| 234,423.60] 322,739.90 5% Calamity Fund 52,990.00 117:211:80 | 117,211.80] 161,369.95 BCPC 21,332.50 73,442.36 23,442.96 32,273.99 Senior Citizen 32,273.99 Total SPAS 498 322.50, = 857,524.96 | _ 637,524.96 937. 7,801,384.25 | 688,206.00] 1,660,030.00] —2,344,236.00 TOTAL EXPENDITURES projected as collectible for the Budget Year. repared by: JARY Ch é “ABILLAS: \y Treasurer Bagdngay Secretary We hereby certify that the information presented above are true and correct. We further certify that the foregoing estimated receipts are reasonable wifes Approved by: ener. Rettoe) Punong Barangay.Republic ofthe Philippines Barangay Sta. Cruz Villaba, Leyte Detailed Balance Shoet December 31, 2021 ASSETS Current Assets cash Cash in Vaul 101 2,928.00 Paty Cash Fund 104 52.00 Payroll Fund 106 47,323.64 ‘Cash in Bank-Local Curren, Current Account 1 1,679,447.66 Receivables Due from LGUs - Advances to Officers and Employees Other Receivables “Total Current Assets avestments and Propery. Plant and Equipment Property, Plant and Equipment & Land : 201 765,805.29 Buildings and Structures Office Buildings 2 1,$44,971.60 Less Accumlated Depreciation Office Buoldings, 311 Other Structures 215 333,990.00, Office Equipment 21 211,734.32 ‘Lose Accumulated Depreciation - Office Equipment 321 Furniture and Fixtures 22 53,702.50 ‘Less Accumulaved Depreciation = Furnvure anni Picture. 322 z 1. T. Equipment & Software 23 49,985.00 Roads, Highways & Bridges 281 234,490.00 ‘Amesian Wels, Reservoirs, Pumping Station & Conduits 254 740,650.00 ‘Total Investments and Property, Plant and Equipment 3,935,328.67 Other Assets : TOTAL ASSETS. STA 026.85 LIABILITIES AND EQUITY Liabilities ‘Current Liabilities Accounts Payable sor 3,035.64 ue to Officers and Employees 403 525.19 Due to BIR 412 17,887.13 Due to LGUs 418, 107,340.00 Other Payables 39 293.00 Total Current Liabilities Tia 96" Other Liabilities ‘Total Liabilities iGareree oe He sol 5,544,945.89 . 5,544,945.89 ‘TOTAL LIABILTIES AND EQUITY COT Prec Certified Correct AR daaes xt