Annex 7

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

A. Certified as to availability of the B. Certified as to availability of C. Certified as to necessity,

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

_________________________ _________________________ ________________________

(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 Name:
Signature Over Printed Name of Payee/
Bank Branch:
Authorized Representative
___________________ OR No.:
Date Date: