Republic of the Philippines

Department of Education
Division of Eastern Samar
Location Code 082604000

Fund Cluster :

DISBURSEMENT VOUCHER Oct., Nov., & Dec. 2022 MOOE

Date:
DV No. :

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

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee MDMCO

Address Maydolong, E. Samar

Responsibility
Particulars MFO/PAP Amount
Center

To payment for the Repair Maintenance-School Building

Expences as per documents attached herewith in the 502 50213040 23,585.00
amount of…..

School ID: 122616

Amount Due 23,585.00
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

ROSALYN A. GUIRALDO
School Treasurer
B. Accounting Entry:
Account Title UACS Code Debit Credit
Repair Maintenance-School Building Expences 50213040 23,585.00
Cash - NT- MDS 10104040 23,585.00

C. Certified: D. Approved for Payment

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

Signature Signature

Printed
Name
BERNARDO A. LONGCOP Printed Name ALJUN G. BORJA

Senior Bookkeeper School Head

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. : DBP - 00-0-01791-720-9
Date : Printed Name: Date
Signature :
MDMCO
Official Receipt No. & Date/Other Documents
 Republic of the Philippines
Department of Education
Division of Eastern Samar
Location Code 082604000

Fund Cluster :

DISBURSEMENT VOUCHER Oct., Nov., & Dec. 2022 MOOE

Date:
DV No. :

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

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee MDMCO

Address Maydolong, E. Samar

Responsibility
Particulars MFO/PAP Amount
Center

To payment for the School Supplies as per documents

attached herewith in the amount of…..
502 302050002 13,000.00

School ID: 122616

Amount Due 13,000.00
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

ROSALYN A. GUIRALDO
School Treasurer
B. Accounting Entry:
Account Title UACS Code Debit Credit
School Supplies 50203010 13,000.00
Cash - NT- MDS 10104040 13,000.00

C. Certified: D. Approved for Payment

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

Signature Signature

Printed
Name
BERNARDO A. LONGCOP Printed Name ALJUN G. BORJA

Senior Bookkeeper School Head

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. : DBP - 00-0-01791-720-9
Date : Printed Name: Date
Signature :
MDMCO
Official Receipt No. & Date/Other Documents