Appendix 32

BOLAOEN ELEMENTARY SCHOOL Fund Cluster :

Entity Name 01
Date
1/12/2020
:
DISBURSEMENT VOUCHER DV No. : 2020-12-0011

Mode of Payment Commercial Check ADA

_________________
TIN/Employee No.: ORS/BURS No.:
Payee VILMA C. DUMLAO
Job Order 2020-12-0011
Address Bugallon , Pangasinan
Responsib
Particulars ility MFO/PAP Amount
Center

PAYMENT for the Job Order 0700108010004 310400100310400 5,000.00

Amount Due 5,000.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

ARLENE V. UNTALAN
PRINCIPAL I

B. Accounting Entry:
UACS Debit Credit
Account Title
Code
Janitorial Services 51212020 5,000.00 -
Cash in Bank - Local Currency, Current Account 1010202024 - 5,000.00

Certified: D. Approved for Payment

/ Cash available

/ Subject to Authority to Debit Account (when applicable)

Five Thousand Pesos Only
/ Suppo Supporting documents complete and amount clai
proper

Signature Signature
Printed
Printed Name BLESILDA MACARAEG ARLENE V. UNTALAN
Name
BOOKKEEPER Principal I
Position Position
Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Date : Bank Name & Account Number: 2020-12-0011
Check/ ADA No. :
829621 12/1/2020 LBP-LINGAYEN / 002422-1065-56
Printed Name: Date
Date :
Signature : VILMA C. DUMLAO
12/1/2020 1/12/2020
Official Receipt No. & Date/Other Documents

92
 Appendix 32

BOLAOEN ELEMENTARY SCHOOL Fund Cluster :

Entity Name 01
: 12/16/2020
DISBURSEMENT VOUCHER DV No. : 2020-12-0014

Mode of
MDS Check / Commercial Check ADA Others (Please specify)
Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee MYRNA O. FERNANDEZ
139-762-269/4122408 2020-12-0014
Address Bolaoen Bugallon, Pangasinan
Responsibility
Particulars Center
MFO/PAP Amount

PAYMENT for theTransportation in receiving the

0700108010004 310400100310400 3,000.00
Food Supplies at the District Office for 60 days

Amount Due 3,000.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

ARLENE V. UNTALAN
PRINCIPAL I
B. Accounting Entry:
Account Title UACS Code Debit Credit
Transportation 50299041 3,000.00 -
Cash in Bank - Local Currency, Current Account 1010202024 - 3,000.00

C. Certified: D. Approved for Payment

/ Cash available

/ Subject to Authority to Debit Account (when applicable)

Three Thousand Pesos Only
/ Supporting documents complete and amount claimed
proper

Signature Signature

Printed
Printed Name BLESILDA MACARAEG ARLENE V. UNTALAN
Name
BOOKKEEPER Principal I
Position Position
Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Bank Name & Account Number: 2020-12-0014
ADA No. : 829632 LBP-LINGAYEN / 002422-106556

Date : Printed Name: Date

Signature :
MYRNA O. FERNANDEZ 12/16/2020
Official Receipt No. & Date/Other
Documents
 Appendix 32
BOLAOEN ELEMENTARY SCHOOL Fund Cluster :
Entity Name Date : 01
DV No. : 12/14/2020
DISBURSEMENT VOUCHER 2020-12-0017

Mode of
MD ADA Others (Please specify)
Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee Jasmine R. Diaz
0031920 2020-12-0017
Address Bolaoen, Bugallon, Pangasinan
Responsibility
Particulars Center
MFO/PAP Amount

PAYMENT for the Electric Bill, Internet Bill,

0700108010004 310400100310400 6,222.48
Telephone Allowance Allowance

Amount Due 6,222.48

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

ARLENE V. UNTALAN
PRINCIPAL I

B. Accounting Entry:
UACS Debit Credit
Account Title
Code
Electricity Expense (10/24/2020-11/23/2020 5020402000 2723.48
Internet Expense (Oct. 24 -Nov.23. 2020) 502050300 1499.000
Telephone Expense (Nov. & Dec. 2020) 502050300 2,000.00 -
101020202 - 6,222.48
Cash in Bank - Local Currency, Current Account
4
C. Certified: D. Approved for Payment
/ Cash available

/ Subject to Authority to Debit Account (when applicable)

Six Thousand Two Hundred Twenty-Two Pesos and 48/100 Only
/ Supporting documents complete and amount claimed
proper

Signature Signature

Printed Printed
BLESILDA MACARAEG ARLENE V. UNTALAN
Name Name
BOOKKEEPER Principal I
Position Position
Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Bank Name & Account Number: 2020-12-0017
ADA
829629 LBP-LINGAYEN / 002422-106556
No. :
Signature Date : Printed Name: Date
: 12/14/2020
Official Receipt No. & Date/Other Documents
 Appendix 32

BOLAOEN ELEMENTARY SCHOOL Fund Cluster :

Entity Name 01
09/24/2021
DISBURSEMENT VOUCHER DV No. : 2021-09-0002

Mode of
MDS Check / Commercial Check ADA Others (Please specify)
Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee LSR Medical Supply
255-035-173-000
Address Bayambang, Pangasinan
Responsibility
Particulars Center
MFO/PAP Amount

PAYMENT for Drugs & Meds & Other Supplies

0700108010004 310400100310400 35,479.50
Expense

Amount Due 35,479.50

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

ARLENE V. UNTALAN
PRINCIPAL I

B. Accounting Entry:
Account Title UACS Code Debit Credit
Drug and Med Supplies 5020307000 35,429.00
Other Supplies Expense 5020321002 50.50 -

Advances for Operating Expenses 1990101000 - 35,479.50

C. Certified: D. Approved for Payment
/ Cash available

/ Subject to Authority to Debit Account (when applicable)

Thirty -Five Thousand Four Hundred Seventy-Nine Pesos & Fifty
Centavos Only
/ Supporting documents complete and amount claimed
proper

Signature Signature

Printed Printed
BLESILDA MACARAEG ARLENE V. UNTALAN
Name Name
BOOKKEEPER Principal I
Position Position
Authorized Representative Agency Head/Authorized Representative
Date Date 09/24/2021
09/24/2021
E. Receipt of Payment JEV No.
Check/ Bank Name & Account Number: LBP- 2021-09-0002
ADA
898237 Printed Name:
LINGAYEN LSR Medical
/ 002422-106556
No. :
Signature Supply Date
Date : 9-22-2021
: 09/24/2021
Official Receipt No. & Date/Other
Documents