You are on page 1of 2

OBLIGATION REQTIEST No : o/-/o//o/ -fr /2- 7zv^

REPUBLIC O}' T}tr PIIlI,II'IINES Dale: P.71- >o>o


DEPARTMENT OF TEE INTERIOR AND LOCAL GOVtrNNMENT Fund Cluster : 0l
REGION 12
Cltv of Koronadal
PaYee DILC SARANGANI PROVINCE

Office DILG XII

Address
Alabel. Sarangani
MFO/PAP UACS Object Amount
Responsibili!y Center Particulars

To rransfer of funds for the payment of


leave monetization intended forthe following in
the amount of....
, _0_100100001000 50202010 00 1 ,512 ,530.11

NAMES Da!,s Amount


T.ABUS, ZORAYDA a7 284,427.10
JOMUAD, MERLITA 177 559,832.57
BALANAG, MELENCIO 90 291,644.72
JEREZ, RODOLF 174 373,221.77

Total 15r2530.1r

Ceraified; Charges to appropria are Certilied: A1lotment ayailable and obligated


necessan - la*firland under mv di upervrsron: and for the purpose.radjustment necessarv as
supporting documents va.lid, legal indicated above

Signature Signature :

DENN I'ATHE
Printed Name: Printed Name

Chief Admin ve O{Iicer /Chief- FAD AO Budaet Section


Position Position :

Date Date .

c STATTJS OF OBLIGATION
Reference Amount
Balance
ORS/JEV/ChecV Obligation Pa\ able Palment Due and
Date Particula$ Not Yet Due
ADA./TRA No. Demandable
(a) (b) (c) (a-b) (b-c)
Utilization 0 1.512.530.1I 1.512.530.11
ck#
TRA

TOTAI >>> 1,512.530.1 I 1.512.530.t1

lpn A,z?
Republt of the Philippines
Daplrtmcnt of thcInt rlor and Local Government
Reglon XII
CE RIIFICATIOTI
Thlr It to CERTIFY th.t tho lnfornrdon .nd oot lG. .rc prGp.rsd in lccordanc€ wlth CSC Msmorandum Circul.r tlo. 41 .. 199E

@li{l.lULATM LEAVE CREDITS AS OF


DATE OF PROPOSED MOI'ETIZATIO l{ET LEAVE
DESIGTIATIOIU SAL GRADE/ YEARS I1{ ocTolER 3L m2O
t{o, I{AME ORIGI]IAL SAI.ARIES CREOITS
POSmOi STEP I CRE
APPOIIITT.I ET
SERVICE YC TTOI{ tlo,
OF O. OF DAYS B LII'CE
TSAVE
SICX LEAVE TOTAL
DAYS VL SL
TOTAL a!,touIT
SOUTH COTABATO
1 ERLITA E
I OMUAD, M LGOO VI 22 2/16/79A9 31 67,933.00 19.500 31S.840 335.340 14.000 157.000 171.000 559,832.s7 t64.340
LABUS, ZORAYDA G LGOO VI 7/2/7ee6 24 6?,933.00 20.000 144.500 164.500 15.000 72.OOO 87.000 284,827.10 7 7.500
3 IEREZ, RODOLF H LGOO VI 22 7/2/199s 25 67,933.00 17.25O 204.250 22l.SO0 12.000 102.000 : -qr{p-q,
373,221-71 107.500
I BALANAG, M ELENCIO IR LGOO VI 22 77/76/7996 24 67,933.00 20.500 150.700 171.200 15.000 75,000 90.000 294,648.72 81.2 00
TOTAL >>> I I 271,732.OO 77.25 815.29 a92.54 56.00 406.00 462.0O 1,512.530.11 430.S4

You might also like