Appendix 32

BANTAY INSIK INTEGRATED SCHOOL Fund Cluster :

Entity Name 07
Date :
DISBURSEMENT VOUCHER DV No. :

Mode of MDS Check / Commercial Check ADA Others (Please specify)

Payment
_________________

Payee TIN/Employee No.: ORS/BURS No.:

Address

Responsibility
Particulars MFO/PAP Amount
Center

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

FLORENCE B. CABUAG, PhD

Asst. Principal II / OIC - Office of the Principal
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable)
Supp
proper

Signature Signature

Printed
Printed Name
Name MARIA CHRISTA A. PAGADUAN FLORENCE B. CABUAG, PhD
ADAS II OIC - Office of the Principal
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date 12/22/2020

E. Receipt of Payment JEV No.

Check/ Date : Bank Name & Account
ADA No. : Number:LBP/ 4062-1017-20
Date : Printed Name: Date
Signature :

Official Receipt No. & Date/Other Documents

92
 Appendix 32

BANTAY INSIK INTEGRATED SCHOOL Fund Cluster :

Entity Name 07
Date :
DISBURSEMENT VOUCHER DV No. :

Mode of MDS Check / Commercial Check ADA Others (Please specify)

Payment
_________________

Payee LA UNION ELECTRIC COOPERATIVE INC. TIN/Employee No.: ORS/BURS No.:

Address

Responsibility
Particulars MFO/PAP Amount
Center

Payment for Electric Expenses for the Month of 4,494.94

April, 2021

Amount Due 4,494.94

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

FLORENCE B. CABUAG, PhD

Asst. Principal II / OIC - Office of the Principal
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit
Electricity Expenses 4,667.12
Due to BIR 172.18
Cash in Bank 4,494.94
C. Certified: D. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
FOUR THOUSAND FOUR HUNDRED NINETY
Supp FOUR PESOS AND 94/100 ONLY
proper

Signature Signature

Printed
Printed Name
Name MARIA CHRISTA A. PAGADUAN FLORENCE B. CABUAG, PhD
ADAS II OIC - Office of the Principal
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.

Check/ Date : Bank Name & Account
ADA No. : Number:LBP/ 4062-1032-27
Date : Printed Name: Date
Signature :

Official Receipt No. & Date/Other Documents

92
 Republic of the Philippines
For BIR BCS/ Department of Finance
Use Only Item: Bureau of Internal Revenue
BIR Form No.
Certificate of Creditable Tax
2307
January 2018 (ENCS)
Withheld at Source 2307 01/18ENCS
Fill in all applicable spaces. Mark all appropriate boxes with an "X".

1 For the Period From 20 21 (MM/DD/YYYY) To 20 21 (MM/DD/YYYY)

Part I – Payee Information

2 Taxpayer Identification Number (TIN)

3 Payee’s Name (Last Name, First Name, Middle Name for Individual OR Registered Name for Non-Individual)

CONVERGE ICT SOLUTIONS INC.

4 Registered Address 4A ZIP Code

URDANETA, PANGASINAN
5

Part II – Payor Information

6 Taxpayer Identification Number (TIN) 000-863-958-7300

7 Payor’s Name (Last Name, First Name, Middle Name for Individual OR Registered Name for Non-Individual)

DEPARTMENT OF EDUCATION, PANGASINAN II

8 Registered Address 8A ZIP Code

BINALONAN, PANGASINAN 2436

Part III – Details of Monthly Income Payments and Taxes Withheld
AMOUNT OF INCOME PAYMENTS
Income Payments Subject to Expanded Tax Withheld for the
ATC 1st Month of the 2nd Month of the 3rd Month of the
Withholding Tax Total Quarter
Quarter Quarter Quarter

Total -
Money Payments Subject to Withholding
of Business Tax (Government & Private)

Total

We declare under the penalties of perjury that this certificate has been made in good faith, verified by us, and to the best of our knowledge and belief, is true and
correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Further, we give our consent to
the processing of our information as contemplated under the *Data Privacy Act of 2012 (R.A. No. 10173) for legitimate and lawful purposes.

FLORENCE B. CABUAG, PhD

SCHOOL HEAD
Signature over Printed Name of Payor/Payor’s Authorized Representative/Tax Agent
(Indicate Title/Designation and TIN)
Tax Agent Accreditation No./ Date of Issue Date of Expiry
Attorney’s Roll No. (if applicable) (MM/DD/YYYY) (MM/DD/YYYY)
CONFORME:

CONVERGE ICT SOLUTIONS INC.

Signature over Printed Name of Payee/Payee’s Authorized Representative/Tax Agent
(Indicate Title/Designation and TIN)
Tax Agent Accreditation No./ Date of Issue Date of Expiry
Attorney’s Roll No. (if applicable) (MM/DD/YYYY) (MM/DD/YYYY)
*NOTE: The BIR Data Privacy is in the BIR website (www.bir.gov.ph)