TIME BOOK AND PAYROLL

For labor on OFFICE OF THE MAYOR et.al. , at LGU Carmen Philippines, for the period March 16 , 20 10 to March 31 , 2010
(State job or project on which labor was performed)

TIME ROLL RESIDENCE

(Mark time each day under proper date using WAGES SIGNATURE CERTIFICATE
NAME fraction when necessary) Net OR THUMB Signature of
No OCCUPATION
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 NUMBER Rate Amount MARK Witness
OF DAYS Per
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 WORKED Day Due NUMBER DATE
1 LEA BRIGOLI O O X X O O O O O X X O O O O X 11 258.22 2,840.42
2 JASMINE MAE MANCAO O O X X O O O O O X X O O O O X 11 200.00 2,200.00
3 BUENAVENTURA APLAYA, JR. O O X X O O O O O X X O O O O X 11 200.00 2,200.00
4 DONESSA RAMOS O O X X O O O O O X X O O O O X 11 200.00 2,200.00
5 JASON LAPE O O X X O O O O O X X O O O O X 11 200.00 2,200.00
6 CORA REMITAR O O X X O O O O O X X O O O O X 11 200.00 2,200.00
7 FRANCISCO FLORES O O X X O O O O O X X O O O O X 11 200.00 2,200.00

TOTAL

1. I HEREBY CERTIFY that each person whose name appears on
this roll rendered service as indicated and for the time stated.
2. I CERTIFY that this roll is correct, every person whose name
appears hereon rendered service for the time and at the rates stated,
under my general supervision,and I approve of this roll.
3. I CERTIFY on my official oath that I have this day
of , 20 paid in cash to each man whose name appears on
the above roll, the amount set opposite his name, he having presented himself, established
his identity, and affixed his signature or thubmark on the space provided therefore Unpaid
services are indicated by red ink through the column " Amount Paid."

ROMMEL S. DALOGDOG JESUS M. CALO ARACELI E. DOMINGUEZ

Foreman or Timekeeper Municipal Mayor Special Disbursing Officer, Paymaster
or Municipal Treasurer
Note: Where thumb mark is to be used in place of signature and the space available is not sufficient the thumb mark may be impressed on the back hereof when
proper indication of the corresponding laborer's numbers and on the corresponding line on the payroll a remark "See thumb mark on the back should be written.
 TIME BOOK AND PAYROLL

Cash Assistance for the Conduct of Basketball Midget Category, at LGU Carmen, Agusan del Norte, Philippines, for the period of May 1- May 31, 2023
(State job or project on which labor was performed)

TIME
(Mark time each day ROLL
under proper date using WAGES RESIDENCE
fraction when necessary) CERTIFICATE
(Mark time each day under proper date using
SIGNATURE OR
NAME fraction when necessary) Net THUMB MARK
No OCCUPATION PAG- PHILHEALT
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 NUMBER Rate IBIG H
Amount Signature of Witness
OF DAYS Per
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 WORKED Day AMOUNT P.S G.S P.S G.S Due NUMBER DATE
1 STEVEN UTLANG CHAMPION 5,000.00 5,000.00
2 MACKJAN CULTURA 1ST PLACE 3,000.00 3,000.00
3 JIMWARD TIMAAN 2ND PLACE 2,000.00 2,000.00

TOTAL 10,000.00 TOTAL 10,000.00

1. I HEREBY CERTIFY that each person whose name appears on
this roll rendered service as indicated and for the time stated.
2. I CERTIFY that this roll is correct, every person whose name
appears hereon rendered service for the time and at the rates stated,
under my general supervision,and I approve of this roll.
3. I CERTIFY on my official oath that I have this day
of , 20 paid in cash to each man whose name appears on
the above roll, the amount set opposite his name, he having presented himself, established
his identity, and affixed his signature or thubmark on the space provided therefore Unpaid
services are indicated by red ink through the column " Amount Paid."

ANN MARJORIE M. BETIO RAMON M. CALO________ ARACELI E. DOMINGUEZ

FSK President Municipal Mayor Disbursing Officer, Paymaster
or Municipal Treasurer

PREPARED BY:

JOANN CANONIGO
SB Staff

Note: Where thumb mark is to be used in place of signature and the space available is not sufficient the thumb mark may be impressed on the back hereof when
proper indication of the corresponding laborer's numbers and on the corresponding line on the payroll a remark "See thumb mark on the back should be written.
 TIME BOOK AND PAYROLL

For labor on Speaker of the Sangguniang Bayan Training/ Seminar, at LGU Carmen Philippines, for the period AUGUST 20, 2019
(State job or project on which labor was performed)

TIME ROLL RESIDENCE

(Mark time each day under proper date using WAGES SIGNATURE CERTIFICATE
NAME fraction when necessary) Net OR THUMB Signature of
No OCCUPATION
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 NUMBER Rate Amount MARK Witness
OF DAYS Per
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 WORKED Day Due NUMBER DATE
1 Romeo J. Gumadlas MBO-Carmen x 1 2,000.00 2,000.00
2 Atty. Ma. Christine Antonette S. Punzalan DILG-Nasipit x 1 2,000.00 2,000.00
3 Laarni Beauty C. Sepe DILG-Carmen x 1 2,000.00 2,000.00

TOTAL 6,000.00

1. I HEREBY CERTIFY that each person whose name appears on
this roll rendered service as indicated and for the time stated.
2. I CERTIFY that this roll is correct, every person whose name
appears hereon rendered service for the time and at the rates stated,
under my general supervision,and I approve of this roll.
3. I CERTIFY on my official oath that I have this day
of , 20 paid in cash to each man whose name appears on
the above roll, the amount set opposite his name, he having presented himself, established
his identity, and affixed his signature or thubmark on the space provided therefore Unpaid
services are indicated by red ink through the column " Amount Paid."

FELOMINO T. PALISAN, JR. RAMON M. CALO ARACELI E. DOMINGUEZ

Foreman or Timekeeper/SB Secretary Municipal Vice Mayor Special Disbursing Officer, Paymaster
or Municipal Treasurer
Note: Where thumb mark is to be used in place of signature and the space available is not sufficient the thumb mark may be impressed on the back hereof when
proper indication of the corresponding laborer's numbers and on the corresponding line on the payroll a remark "See thumb mark on the back should be written.
 TIME BOOK AND PAYROLL

For labor on OFFICE OF THE MAYOR et.al. , at LGU Carmen Philippines, for the period March 16 , 20 10 to March 31 , 2010
(State job or project on which labor was performed)

TIME ROLL RESIDENCE

(Mark time each day under proper date using WAGES SIGNATURE CERTIFICATE
NAME fraction when necessary) Net OR THUMB Signature of
No OCCUPATION
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 NUMBER Rate Amount MARK Witness
OF DAYS Per
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 WORKED Day Due NUMBER DATE
1
2
3
4
5
6
7
8

TOTAL

1. I HEREBY CERTIFY that each person whose name appears on
this roll rendered service as indicated and for the time stated.
2. I CERTIFY that this roll is correct, every person whose name
appears hereon rendered service for the time and at the rates stated,
under my general supervision,and I approve of this roll.
3. I CERTIFY on my official oath that I have this day
of , 20 paid in cash to each man whose name appears on
the above roll, the amount set opposite his name, he having presented himself, established
his identity, and affixed his signature or thubmark on the space provided therefore Unpaid
services are indicated by red ink through the column " Amount Paid."

ROMMEL S. DALOGDOG JESUS M. CALO ARACELI E. DOMINGUEZ

Foreman or Timekeeper Municipal Mayor Special Disbursing Officer, Paymaster
or Municipal Treasurer
Note: Where thumb mark is to be used in place of signature and the space available is not sufficient the thumb mark may be impressed on the back hereof when
proper indication of the corresponding laborer's numbers and on the corresponding line on the payroll a remark "See thumb mark on the back should be written.
For labor on , at LGU Carmen Philippines, for the period October
December
16-31,2017
1-15,2017
(State job or project on which labor was performed)

TIME ROLL
(Mark time each day under proper date using WAGES Net RESIDENCE
CERTIFICATE

NAME fraction when necessary) Deduction Deduction Amount SIGNATURE OR Signature of

No Total Philhealth THUMB
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 NUMBER
Rate Pag-ibig Prem.
MARK
Witness
Per
DESIGNATION 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
OF DAYS
WORKED Day Amount PS GS P.S. G.S. NUMBER DATE

x x x x x x x x x x x x x x x
1 FRANCISCO FLORES UTILITY 15 250.00 3,750.00 3,750.00
2

5
6
7
8
9
10

TOTAL 3,750.00
3,750.00
1. I HEREBY CERTIFY that each person whose name appears on 2. I CERTIFY that this roll is correct, every person whose name 3. I CERTIFY on my official oath that I have this day
this roll rendered service as indicated and for the time stated. appears hereon rendered service for the time and at the rates stated, of , 20 paid in cash to each man whose name appears on

under my general supervision,and I approve of this roll. the above roll, the amount set opposite his name, he having presented himself, established

his identity, and affixed his signature or thubmark on the space provided therefore Unpaid

services are indicated by red ink through the column " Amount Paid."

WLFREDO T. TAGLUCOP WILFREDO T. TAGLUCOP ARACELI E. DOMINGUEZ

Municipal Vice Mayor Municipal Vice Mayor Special Disbursing Officer, Paymaster
or Municipal Treasurer
Note: Where thumb mark is to be used in place of signature and the space available is not sufficient the thumb mark may be impressed on the back hereof when
proper indication of the corresponding laborer's numbers and on the corresponding line on the payroll a remark "See thumb mark on the back should be written.