LGU-HINABANGAN, SAMAR

PAYROLL
WE HEREBY AKNOWLEDGE to have received from CLARITA D. GAVION/ SDO of Hinabangan, Samar the sum herein specified opposite our respective names, the same being full compensation for our service rendered during the
period stated below the correctness of which we hereby generally certifiy.

Wages of the Referee of the Basketball Competition for the Hinabangan Day Celebration.

No. NAME DESIGNATION RATE per Day INCLUSIVE DAY/S AMOUNT DUE SIGNATURE

1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
TOTAL - -

1. I HEREBY CERTIFY on my official oath that the above 2. APPROVED payable from Appropriation 3. I CERTIFY on my officials I oath that I have paid to each employees name appears on the above roll
payroll in correct, and that service have been duly the amount set opposite his/ her name.
rendered as stated.

HON. CLARITO P. ROSAL VIRGINIA B. CARDENAS CLARITA GAVION

Municipal Mayor OIC - Municipal Budget Officer SDO