Annex PSA-CTCO-SS-SPPD-1602-01-04

SAMPLE

MEMORANDUM OF AGREEMENT

FINANCIAL REQUIREMENTS FOR THE ACTIVITIES

OF THE 27th NATIONAL STATISTICS MONTH (NSM)

KNOW ALL MEN BY THESE PRESENTS:

This Memorandum of Agreement entered into by and between the following

parties:

The PHILIPPINE STATISTICS AUTHORITY (PSA), with principal

address at 3rdFloor, CVEA Building, East Avenue, Diliman, Quezon City,
and represented by its National Statistician, LISA GRACE S.
BERSALES;
and
The (NAME OF AGENCY), with principal address at (agency address)
and represented by its (Designation), (NAME OF AGENCY HEAD);

WHEREAS, under Presidential Proclamation No. 647, the National Statistics

Month (NSM) shall be held every October with the following two-fold objectives: (a) to
promote, enhance and instill nationwide awareness and appreciation of the importance
and value of statistics to the different sectors of the society; and (b) to elicit the
cooperation and support of the general public in upgrading the quality and standard of
statistics in the country;

WHEREAS, PSA Memorandum Circular No. 01-2016 dated 29January

2016enjoins all agencies of the government, local government units, academic
institutions, and the private sector at the national and subnational levels to actively
participate in and support the celebration of the 27th National Statistics Month in
October 2016;

WHEREAS, the 27thNSM celebration shall have for its theme

“Sustainable Development: Making Statistics Count”

WHEREAS, the above Memorandum Circular provides that the participating

agencies shall earmark funds for their respective agencies as well as common
activities for the 27thNSM;

WHEREAS, the Memorandum Circular provides among others, that

participating agencies shall be requested to contribute at leastFifteenThousand
Pesos (P15,000.00) each, payable toPhilippine Statistics Authority (PSA), to fund
all NSM inter-agency activities from preparatory work, celebration proper, to post
evaluation.

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 Annex PSA-CTCO-SS-SPPD-1602-01-04

NOW, THEREFORE, for and in consideration of the foregoing premises, the

contracting parties hereby agree to the following:

1. The (Name of Agency) shall contribute at least FIFTEEN THOUSAND

PESOS (PhP 15,000.00) to cover the expenses for the 27thNSM
activities which shall be made payable toPSAwithin 30 days from the
signing of contract;and

2. The PSA shall acknowledge receipt of funds, deposit the same with the
Bureau of Treasury in accordance with E. O. 338, series of 1996, and
utilize the funds for the purpose of the 27th NSM celebration and subject
to existing accounting and auditing rules and regulations;

This Agreement shall take effect upon signing by the contracting parties.
Modifications may be made upon written consent of all parties.

IN WITNESS WHEREOF, the parties have hereto set their hands at the City of
______________ this ____ day of __________ 2016.

LISA GRACE S. BERSALES NAME OF AGENCY HEAD

National Statistician Designation
and Civil Registrar General Name of Agency
Philippine Statistics Authority

Signed in the presence of

CANDIDO J. ASTROLOGO, JR. _______________________Witness

Witness

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 Annex PSA-CTCO-SS-SPPD-1602-01-04

ACKNOWLEDGMENT

Republic of the Philippines )

Makati City ) ss

BEFORE ME, this ____ day of _________ at ___________________,

Philippines, personally appeared Lisa Grace S. Bersales of Philippine Statistics
Authority (PSA)with ID No.___________issued on24 June 2014at Manila and
_____________ of _____________ with ID No. ______________________ issued on
______________________at _____________________, known to me to be the same
persons who executed the foregoing instruments and acknowledged to me that the
same is their free act and deed.

This instrument, consisting of (3) pages including this one on which the
acknowledgment is written, has been signed on the left hand margin of each page
thereof by said parties and their instrumentals, and sealed with my notarial seal.

IN WITNESS WHEREOF, I have hereunto set my hand and seal on the day, in
the year and place above written.

Doc. no. ______________

Page no. ______________
Book no. ______________
Series of ______________

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