Republic of the Philippines Department of DBP Regional Office No.

XVI, Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Establishment of petty cash fund P □ MDS Check Mrs. Ena Money Responsibility Center Office/Unit/Project Code: AMOUNT 20,000.00 No.: 08 -12 – 01 Date: December 04, 2008 □ ADA □ Others

□ Commercial Check

TIN/Employee No. OR/BUR No.

A

CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete

P B

20,000.00 APPROVED FOR PAYMENT

Signature: ______(Sgd.)_______ Printed Name: Ms. Joy Masipag Position: Chief Accountant Date: December 04, 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. 3200101 12/04/08 Signature: Date: Official Receipt/Other Documents:

Signature: ______(Sgd.)_______ Printed Name: Mr. Doroteo Model Position: Regional Director Date: December 04, 2008 JEV No. Bank Name: Printed Name: 004 Date: 12/04/08

Republic of the Philippines Department of DBP Regional Office No. XVI, Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Comprehensive insurance of vehicle P □ MDS Check GSIS Responsibility Center Office/Unit/Project Code: AMOUNT 40,000.00 No.: 08 -12 – 02 Date: December 08, 2008 □ ADA □ Others

□ Commercial Check

TIN/Employee No. OR/BUR No.

A

CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete

P B

40,000.00 APPROVED FOR PAYMENT

Signature: ______(Sgd.)_______ Printed Name: Ms. Joy Masipag Position: Chief Accountant Date: December 08, 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. 3200102 12/08/08 Signature: Date: Official Receipt/Other Documents:

Signature: ______(Sgd.)_______ Printed Name: Mr. Doroteo Model Position: Regional Director Date: December 08, 2008 JEV No. Bank Name: Printed Name: 005 Date: 12/08/08

Republic of the Philippines Department of DBP Regional Office No. XVI, Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Net salaries for December 1-15, 2008 P □ MDS Check Mrs. Ena Money Responsibility Center Office/Unit/Project Code: AMOUNT 180,300.00 No.: 08 -12 – 03 Date: December 11, 2008 □ ADA □ Others

□ Commercial Check

TIN/Employee No. OR/BUR No.

A

CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete

P B

180,300.00 APPROVED FOR PAYMENT

Signature: ______(Sgd.)_______ Printed Name: Ms. Joy Masipag Position: Chief Accountant Date: December 11, 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. 3200103 12/11/08 Signature: Date: Official Receipt/Other Documents:

Signature: ______(Sgd.)_______ Printed Name: Mr. Doroteo Model Position: Regional Director Date: December 11, 2008 JEV No. Bank Name: Printed Name: 005 Date: 12/11/08

300.300.)_______ Printed Name: Ms. 2008 P □ MDS Check Mrs.: 08 -12 – 03 Date: December 11. 2008 JEV No.Republic of the Philippines Department of DBP Regional Office No. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 180.)_______ Printed Name: Mr. 3200103 12/11/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. Bank Name: Printed Name: 005 Date: 12/11/08 .00 APPROVED FOR PAYMENT Signature: ______(Sgd.00 No. Ena Money Responsibility Center Office/Unit/Project Code: AMOUNT 180. Doroteo Model Position: Regional Director Date: December 11. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Net salaries for December 1-15. XVI. OR/BUR No. Joy Masipag Position: Chief Accountant Date: December 11.

oil & lubricants P □ MDS Check No. XVI.Republic of the Philippines Department of DBP Regional Office No. OR/BUR No.000.)_______ Printed Name: Ms. Doroteo Model Position: Regional Director Date: December 13. Joy Masipag Position: Chief Accountant Date: December 13.00 A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 4. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. Bank Name: Printed Name: 009 Date: 12/13/08 .00 APPROVED FOR PAYMENT Signature: ______(Sgd. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Payment fuel. 3200104 12/13/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. 2008 JEV No.000.: 08 -12 – 04 Date: December 13.)_______ Printed Name: Mr. Leo Shell Service Center Responsibility Center Office/Unit/Project Code: AMOUNT 4.

600.00 No. Lito Freeman Responsibility Center Office/Unit/Project Code: AMOUNT 15. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 15. XVI.)_______ Printed Name: Mr.)_______ Printed Name: Ms.: 08 -12 – 05 Date: December 17. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Cash advance for travelling to Cebu City P □ MDS Check Mr.Republic of the Philippines Department of DBP Regional Office No. Bank Name: Printed Name: 010 Date: 12/17/08 . 3200105 12/17/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. OR/BUR No.600. Joy Masipag Position: Chief Accountant Date: December 17. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. Doroteo Model Position: Regional Director Date: December 17. 2008 JEV No.00 APPROVED FOR PAYMENT Signature: ______(Sgd.

XVI. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. Doroteo Model Position: Regional Director Date: December 18.00 No.)_______ Printed Name: Ms. 3200106 12/18/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd.)_______ Printed Name: Mr.Republic of the Philippines Department of DBP Regional Office No. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Payment for the purchase of computer & software P □ MDS Check ACER Philippines Responsibility Center Office/Unit/Project Code: AMOUNT 160.: 08 -12 – 06 Date: December 18. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No.000. OR/BUR No.000. Joy Masipag Position: Chief Accountant Date: December 18. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 160. Bank Name: Printed Name: 011 Date: 12/18/08 . 2008 JEV No.00 APPROVED FOR PAYMENT Signature: ______(Sgd.

OR/BUR No. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Replacement of cancelled check issued for the purchase of office supplies P □ MDS Check National Bookstore Responsibility Center Office/Unit/Project Code: AMOUNT 11.)_______ Printed Name: Ms.00 No. XVI. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. 2008 JEV No. Joy Masipag Position: Chief Accountant Date: December 20.)_______ Printed Name: Mr.00 APPROVED FOR PAYMENT Signature: ______(Sgd.000.: 08 -12 – 07 Date: December 20. P A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete Signature: ______(Sgd.Republic of the Philippines Department of DBP Regional Office No.000. Bank Name: Printed Name: 012 Date: 12/20/08 . 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. 3200107 12/20/08 Signature: Date: Official Receipt/Other Documents: B 11. Doroteo Model Position: Regional Director Date: December 20.

00 No. OR/BUR No. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No.00 APPROVED FOR PAYMENT Signature: ______(Sgd. 3200108 12/20/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Seminar fee of 2 personnel P □ MDS Check SAADO Responsibility Center Office/Unit/Project Code: AMOUNT 12. Doroteo Model Position: Regional Director Date: December 20. Joy Masipag Position: Chief Accountant Date: December 20. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 12.: 08 -12 – 08 Date: December 20. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No.000. XVI. Bank Name: Printed Name: 014 Date: 12/20/08 .)_______ Printed Name: Mr.Republic of the Philippines Department of DBP Regional Office No. 2008 JEV No.000.)_______ Printed Name: Ms.

000.00 No. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Payment for the purchase of tires P □ MDS Check Best Auto Supply Responsibility Center Office/Unit/Project Code: AMOUNT 10. Bank Name: Printed Name: 015 Date: 12/23/08 . 2008 □ ADA □ Others □ Commercial Check TIN/Employee No.Republic of the Philippines Department of DBP Regional Office No. OR/BUR No.)_______ Printed Name: Ms. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 10. Doroteo Model Position: Regional Director Date: December 23. 3200109 12/23/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd.)_______ Printed Name: Mr.: 08 -12 – 09 Date: December 23. XVI.00 APPROVED FOR PAYMENT Signature: ______(Sgd.000. Joy Masipag Position: Chief Accountant Date: December 23. 2008 JEV No. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No.

)_______ Printed Name: Ms. Doroteo Model Position: Regional Director Date: December 23.00 No. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. Joy Masipag Position: Chief Accountant Date: December 23.00 APPROVED FOR PAYMENT Signature: ______(Sgd.000.000. Bank Name: Printed Name: 016 Date: 12/23/08 . 2008 JEV No. 3200110 12/23/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 26.Republic of the Philippines Department of DBP Regional Office No. XVI.)_______ Printed Name: Mr. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Purchase of office supplies P □ MDS Check National Bookstore Responsibility Center Office/Unit/Project Code: AMOUNT 26. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. OR/BUR No.: 08 -12 – 10 Date: December 23.

: 08 -12 – 11 Date: December 26. OR/BUR No. 2008 JEV No.Republic of the Philippines Department of DBP Regional Office No. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. Ena Money Responsibility Center Office/Unit/Project Code: AMOUNT 180. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Cash advance for salaries & wages ( Dec. 3200111 12/26/08 Signature: Date: Official Receipt/Other Documents: B 180. P A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete Signature: ______(Sgd.)_______ Printed Name: Mr.00 No. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. Bank Name: Printed Name: 018 Date: 12/26/08 . 2008) P □ MDS Check Mrs. XVI.)_______ Printed Name: Ms. Joy Masipag Position: Chief Accountant Date: December 26. Doroteo Model Position: Regional Director Date: December 26.300.00 APPROVED FOR PAYMENT Signature: ______(Sgd.300. 16-31.

Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Payment for water bill P □ MDS Check LMWD Responsibility Center Office/Unit/Project Code: AMOUNT 20.900. 3200112 12/26/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. Joy Masipag Position: Chief Accountant Date: December 26. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No.: 08 -12 – 12 Date: December 26.00 No.)_______ Printed Name: Ms.00 APPROVED FOR PAYMENT Signature: ______(Sgd. XVI. OR/BUR No. 2008 JEV No.900. Bank Name: Printed Name: 020 Date: 12/26/08 .)_______ Printed Name: Mr. Doroteo Model Position: Regional Director Date: December 26. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 20.Republic of the Philippines Department of DBP Regional Office No.

XVI.: 08 -12 – 13 Date: December 27. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Payment for electric bill P □ MDS Check LEYECO Responsibility Center Office/Unit/Project Code: AMOUNT 51. OR/BUR No.00 No. Doroteo Model Position: Regional Director Date: December 27.)_______ Printed Name: Ms.00 APPROVED FOR PAYMENT Signature: ______(Sgd.)_______ Printed Name: Mr.510.Republic of the Philippines Department of DBP Regional Office No. 3200113 12/27/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. 2008 JEV No. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. Joy Masipag Position: Chief Accountant Date: December 27. Bank Name: Printed Name: 021 Date: 12/27/08 . A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 51.510.

Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Payment for telephone bill P □ MDS Check EVTELCO Responsibility Center Office/Unit/Project Code: AMOUNT 30.)_______ Printed Name: Ms.460. 2008 JEV No. XVI. Joy Masipag Position: Chief Accountant Date: December 27. OR/BUR No.00 No.Republic of the Philippines Department of DBP Regional Office No.)_______ Printed Name: Mr. Doroteo Model Position: Regional Director Date: December 27.460. 3200114 12/27/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd.00 APPROVED FOR PAYMENT Signature: ______(Sgd. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 30. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. Bank Name: Printed Name: 022 Date: 12/27/08 .: 08 -12 – 14 Date: December 27.

: 08 -12 – 15 Date: December 27. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Remittance of withholding tax P □ MDS Check No.Republic of the Philippines Department of DBP Regional Office No.400. XVI. 3200115 12/27/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. Bank Name: Printed Name: 023 Date: 12/27/08 .)_______ Printed Name: Mr.)_______ Printed Name: Ms. 2008 JEV No. OR/BUR No. Bureau of Internal Revenue Responsibility Center Office/Unit/Project Code: AMOUNT 17.400.00 APPROVED FOR PAYMENT Signature: ______(Sgd. Doroteo Model Position: Regional Director Date: December 27.00 A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 17. Joy Masipag Position: Chief Accountant Date: December 27.

: 08 -12 – 16 Date: December 30.)_______ Printed Name: Ms. Bank Name: Printed Name: 024 Date: 12/30/08 .000.Republic of the Philippines Department of DBP Regional Office No. Doroteo Model Position: Regional Director Date: December 30. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Employee & loan remittance P □ MDS Check GSIS Responsibility Center Office/Unit/Project Code: AMOUNT 115.00 APPROVED FOR PAYMENT Signature: ______(Sgd. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. XVI. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No.)_______ Printed Name: Mr. 2008 JEV No. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 115. 3200116 12/30/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. Joy Masipag Position: Chief Accountant Date: December 30. OR/BUR No.00 No.000.

A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 60. Doroteo Model Position: Regional Director Date: December 30.000.00 No.: 08 -12 – 17 Date: December 30.00 APPROVED FOR PAYMENT Signature: ______(Sgd. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Government contribution P □ MDS Check GSIS Responsibility Center Office/Unit/Project Code: AMOUNT 60.)_______ Printed Name: Ms. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. XVI. OR/BUR No.Republic of the Philippines Department of DBP Regional Office No. Joy Masipag Position: Chief Accountant Date: December 30. Bank Name: Printed Name: 025 Date: 12/30/08 . 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. 3200117 12/30/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd.)_______ Printed Name: Mr. 2008 JEV No.000.

)_______ Printed Name: Ms. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 3.)_______ Printed Name: Mr.: 08 -12 – 18 Date: December 30.00 APPROVED FOR PAYMENT Signature: ______(Sgd.Republic of the Philippines Department of DBP Regional Office No. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No.00 No. 2008 JEV No. OR/BUR No.000. Doroteo Model Position: Regional Director Date: December 30. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. Bank Name: Printed Name: 026 Date: 12/30/08 . 3200118 12/30/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd.000. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Employee & loan remittance P □ MDS Check PHILHEALTH Responsibility Center Office/Unit/Project Code: AMOUNT 3. Joy Masipag Position: Chief Accountant Date: December 30. XVI.

A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 3. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Government contribution P □ MDS Check PHILHEALTH Responsibility Center Office/Unit/Project Code: AMOUNT 3. Doroteo Model Position: Regional Director Date: December 30.00 No.)_______ Printed Name: Ms. 2008 JEV No.Republic of the Philippines Department of DBP Regional Office No. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No.000. XVI. Joy Masipag Position: Chief Accountant Date: December 30.000. 3200119 12/30/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. OR/BUR No.00 APPROVED FOR PAYMENT Signature: ______(Sgd. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. Bank Name: Printed Name: 027 Date: 12/30/08 .: 08 -12 – 19 Date: December 30.)_______ Printed Name: Mr.

: 08 -12 – 20 Date: December 30.000.IBIG Responsibility Center Office/Unit/Project Code: AMOUNT 4.)_______ Printed Name: Ms. Joy Masipag Position: Chief Accountant Date: December 30.Republic of the Philippines Department of DBP Regional Office No. 2008 JEV No. 3200120 12/30/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Employee & loan remittance P □ MDS Check PAG . Doroteo Model Position: Regional Director Date: December 30. XVI.)_______ Printed Name: Mr. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. OR/BUR No.000. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No.00 No.00 APPROVED FOR PAYMENT Signature: ______(Sgd. Bank Name: Printed Name: 028 Date: 12/30/08 . A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 4.

Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Government contribution P □ MDS Check PAG . 3200121 12/30/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. Doroteo Model Position: Regional Director Date: December 30.Republic of the Philippines Department of DBP Regional Office No.000. Joy Masipag Position: Chief Accountant Date: December 30. Bank Name: Printed Name: 029 Date: 12/30/08 .00 APPROVED FOR PAYMENT Signature: ______(Sgd. XVI.)_______ Printed Name: Mr.IBIG Responsibility Center Office/Unit/Project Code: AMOUNT 4. OR/BUR No.000.: 08 -12 – 21 Date: December 30.)_______ Printed Name: Ms. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 4. 2008 JEV No.00 No.

00 No. XVI. 3200122 12/30/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. Ena Money Responsibility Center Office/Unit/Project Code: AMOUNT 13. Joy Masipag Position: Chief Accountant Date: December 30.)_______ Printed Name: Mr. Doroteo Model Position: Regional Director Date: December 30. OR/BUR No.: 08 -12 – 22 Date: December 30.530. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Replenishment of petty cash fund P □ MDS Check Mrs.00 APPROVED FOR PAYMENT Signature: ______(Sgd. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 13.)_______ Printed Name: Ms. Bank Name: Printed Name: 030 Date: 12/30/08 . 2008 JEV No.Republic of the Philippines Department of DBP Regional Office No. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No.530.

2008 JEV No. OR/BUR No.Republic of the Philippines Department of DBP Regional Office No. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No.000. XVI.)_______ Printed Name: Mr. 3200123 12/30/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd. Joy Masipag Position: Chief Accountant Date: December 30. Doroteo Model Position: Regional Director Date: December 30. A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 40.00 APPROVED FOR PAYMENT Signature: ______(Sgd.00 No. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No.)_______ Printed Name: Ms.: 08 -12 – 23 Date: December 30.000. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Payyment for advance rental for 2 months P □ MDS Check DPWH Responsibility Center Office/Unit/Project Code: AMOUNT 40. Bank Name: Printed Name: 031 Date: 12/30/08 .

2008 JEV No. XVI. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Retirement gratuity P □ MDS Check No.000.00 A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 500.000.00 APPROVED FOR PAYMENT Signature: ______(Sgd. Doroteo Model Position: Regional Director Date: December 30.)_______ Printed Name: Ms. 2008 C RECEIVED PAYMENT CHECK/ADA Date: No.: 08 -12 – 24 Date: December 30. OR/BUR No. 3200124 12/30/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd.Republic of the Philippines Department of DBP Regional Office No.)_______ Printed Name: Mr. Anagap Responsibility Center Office/Unit/Project Code: AMOUNT 500. Mr. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No. Marcelo N. Bank Name: Printed Name: 032 Date: 12/30/08 . Joy Masipag Position: Chief Accountant Date: December 30.

: 08 -12 – 25 Date: December 30.500. Doroteo Model Position: Regional Director Date: December 30. 2008 □ ADA □ Others □ Commercial Check TIN/Employee No.)_______ Printed Name: Ms. Land Bank of the Philippines Responsibility Center Office/Unit/Project Code: AMOUNT 1. 2008 JEV No. OR/BUR No. XVI.Republic of the Philippines Department of DBP Regional Office No. Joy Masipag Position: Chief Accountant Date: December 30. Bank Name: Printed Name: 033 Date: 12/30/08 . 2008 C RECEIVED PAYMENT CHECK/ADA Date: No.500. 3200125 12/30/08 Signature: Date: Official Receipt/Other Documents: Signature: ______(Sgd.00 A CERTIFIED □ Cash available □ Subject to Authority to Debit Account □ Supporting documents complete P B 1.)_______ Printed Name: Mr.00 APPROVED FOR PAYMENT Signature: ______(Sgd. Marunong City DISBURSEMENT VOUCHER Mode of Payment: Payee: Address: EXPLANATION Bank charges P □ MDS Check No.

CHECK DISBURSEMENT RECORD CASH DISBURSEMENT RECORD ITINERARY OF TRAVEL PETTY CASH VOUCHER PETTY CASH REPLENISHMENT REPORT CHECK DISBUSEMENT JOURNAL & CASH DISBUSEMENT JOURNAL .

780.00 1.00 4.00 60.256.600.00 1.00 1.00 1250.000.000.700.00 180.500.00 1.500. 2008__inclusive.00 500.00 26.000. Marunong City Period Covered: Dec.800.000. Anagap Land Bank of the Philippines I hereby certify that the foregoing is a correct and complete record of all Check issued made by me in my capacity as ___collecting & disbursing officer__ of Department of DBP Regional Office No.00 1.00 4.732. 2008__to __Dec.280.176-02 Receipt of SARO.253.00 3.530.454.000.00 1.000.530.00 1.00 500.229.16-31.00 51.00 1.100. Contribution Employee Share Gov’t Contribution Employee Share Gov’t Contribution Replenishment of Petty Cash Fund Advance rental for 2 months Retirement Gratuity Bank Charges CERTIFICATION NCA Received/Deposit made 1.00 13.2008_ Date .00 1.680.00 1.00 12.530.00 1.00 Check Issued Bank/ NCA Balance 1.00 1. as indicated in the corresponding columns.000.440.2008 Payment of Water Bill Payment of Electric Bill Payment of Telephone-Landline Withholding tax Employee and Loan remittance Gov’t.00 40.00 1. 1-30.00 __Disbursing Officer__ Official Designation Report No.300.00 115.479.000.00 1.000.00 1. Ena Money_ Accountable Officer Check Date Dec 3 4 8 11 13 17 18 19 20 20 20 23 23 26 26 27 27 27 30 30 30 30 30 30 30 30 30 30 Number Date Released 12-04-08 12-08-08 12-11-08 12-13-08 12-17-08 12-18-08 Name of Payee Nature of Payment Receipt of NCA 176-01 Petty Cash Fund Comprehensive Insurance of Vehicle Salaries and Wages for Dec 31 Purchase of Fuel Cash Allowance for travel to Cebu Purchase of Computer software Receipt of SARO.530.00 1.00 4.000.768.455.00 1.640.100.100.000. Mrs.530.00 11. 2008 Mrs.000. XVI.246.100.900.000.00 1.00 1.530.00 1.431.00 11.242.000.00 1.390.000. 1 __________________ Station 3200101 3200102 3200103 3200104 3200105 3200106 Ena Money GSIS Ena Money Leo Shell Service Center Lito Freemen ACER Philippines 3200107 3200108 3200109 3200110 3200111 3200112 3200113 3200114 3200115 3200116 3200117 3200118 3200119 3200120 3200121 3200122 3200123 3200124 3200125 12-20-08 12-20-08 12-20-08 12-23-08 12-23-08 12-26-08 12-26-08 12-27-08 12-27-08 12-27-08 12-30-08 12-30-08 12-30-08 12-30-08 12-30-08 12-30-08 12-30-08 12-30-08 12-30-08 National Bookstore SAADO Best Auto Supply National Bookstore Ena Money LMWD LEYECO EVTELCO Bureau Of Internal Revenue GSIS GSIS PHILHEALTH PHILHEALTH PAG-IBIG PAG-IBIG Ena Money DPWH Marcelo N.000.00 17.700.000.00 3.700.551.000.000.100.000.530.00 20.000.NCA No.930.00 1.00 30.NCA No.530.758.100. 176-03 Replacement of cancelled check Seminar fee Purchase of tires Purchase of office supplies Net Salaries & Wages-Dec.300.000.780.000.00 10.100.00 687. Ena Money___ Name & Signature December 30.00 1.448.000.000.00 160.30.CHECK DISBURSEMENT RECORD Department of DBP Regional Office NO.510.900.00 15.00 1.316.100. 1.400.00 40.00 1.00 180.189. XVI During the period from __Dec.530.000.460.791.00 689.00 20.

Marunong City Mrs.2008_ Date .300 -000 00 12-11-08 12-15-08 12-26-08 12-30-08 Mrs. Ena Money Cash .300 08-12-11 Mrs. Ena Money___ Name & Signature December 30.Payroll Fund 180. 08-12-03 Name of Payee __Disbursing Officer__ Official Designation Nature of Payment Cash Advance Received P 180.CASH DISBURSEMENT RECORD Department of DBP Regional Office No. Ena Money_ Accountable Officer Date Reference/ Payroll No. XVI. Ena Money Cash – Payroll Fund CERTIFICATION I hereby certify that the foregoing is a correct and complete record of all cash advances for received and disbursements made made by me in my capacity as _collecting & disbursing officer__ of Department of DBP Regional Office No.30. 1.300 0 0 0 0 __________________ Station Disbursement Cash Advance Balance P 180. as indicated in the corresponding columns. XVI During the period from __Dec.300 0 0 180.300 0 0 180. 2008__to __Dec.300 -0180. Mrs./ DV No. 2008__inclusive.

000. Ena Money Disbursing Officer December 30. Ena Money GSIS MRS.00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 CERTIFICATION I hereby certify that this Report of Checks Issued in _2_ sheet(s) is a Full. XVI.510 30.300 20.true and correct statement of all checks released by me in my payment for obligations for the period stated and shown in the attached disbursement voucher.000 4.000 180.000 10. Check DV No. 1-15.REPORT OF CHECK ISSUED Department of DBP Regional Office No.) Mrs. Ena Money LEO Shell Service Center Lito Freemen ACER Philippines National Bookstore SAADO Best Auto Supply National Bookstore Ena Money LMWD LEYECO EVTELCO Bureau Of Internal Revenue GSIS GSIS PHILHEALTH PHILHEALTH PAG-IBIG PAG-IBIG Ena Money DPWH Marcelo N.460 17.000 4.000 180.000 3./ Payroll Date No.000 13.400 115. 2008 Fuel.000 15. Marunong City Period Covered: December 1-30. Anagap Land Bank of the Philippines Report No.500.600 160.000 3.16-31.00 1.000 12. 4 3200101 08-12-01 8 3200102 08-12-02 11 3200103 08-12-03 13 3200104 08-12-04 17 3200105 08-12-05 18 3200106 08-12-06 20 3200107 08-12-07 20 3200108 08-12-08 23 3200109 08-12-09 23 3200110 08-12-10 26 3200111 08-12-11 26 3200112 08-12-12 27 3200113 08-12-13 27 3200114 08-12-14 27 3200115 08-12-15 30 3200116 08-12-16 30 3200117 08-12-17 30 3200118 08-12-18 30 3200119 08-12-19 30 3200120 18-12-20 30 3200121 08-12-21 30 3200122 08-12-22 30 3200123 08-12-23 30 3200124 08-12-24 30 3200125 08-12-25 Responsibility Center Code Payee Mrs.2008 Payment of Water Bill Payment of Electric Bill Payment of Telephone-Landline Withholding tax Employee and Loan remittance Gov’t.2008 Date . Dec. 1 Sheet No. Dec . 2008 Bank Name/Account No. Contribution Employee Share Gov’t Contribution Employee Share Gov’t Contribution Replenishment of Petty Cash Fund Advance rental for 2 months Retirement Gratuity Bank Charges P Amount 20.000 500. Oil & Lubricants Cash advance for travel to Cebu Purchase of computer & software Replacement of cancelled check Seminar fee Purchase of tires Purchase of office supplies Net Salaries & Wages-Dec.000 40. 1 Nature of Payment Establishment of petty cash fund Comprehensive insurance of vehicle Net salaries & wages.900 51.000 60.300 4.000 11.530 40. (Sgd.000 26.

00 1.00 400.000. (d) the expenses Claimed are proper.M.00 TOTAL TOTAL AMOUNT P 6. Doroteo Model .Republic of the Philippines Department of DBP Regional Office No.00 P 15. (Sgd.M.200.00 800.00 P 800. Regional Office No.00 400.200.00 6. Ena Money______ Supervisor Prepared by: Itinerary. 8:00 A.000. XVI.00 1.) Mrs. Marunong City Date: December 16. (b) the travel is Mr. Monthly Salary: ______ MEANS OF TRANSPORTATION Airplane Taxi Taxi Taxi Airplane ALLOWABLE EXPENSES TRANSPO PER DIEMS P 5. Lito Freeman Position: Employee_ Official Station: Department of DBP.200 800.00 I CERTIFY THAT: (a) I have reviewed the foregoing necessary to the services. (c) the period covered is reasonable.00 5. Lito Freeman Approved by: Mr.00 400. 12-19-08 Still in Cebu 12-20-08 Still in Cebu 12-21-08 Still in Cebu 12-22-08 Arrival in Marunong 1:00 P.200. 2:00 P.M.00 800. 2008 ITINERARY OF TRAVEL Name: Mr. XVI Purpose of Travel: Seminar DATE PLACES TO BE TIME VISITED DEPARTURE ARRIVAL 12-18-08 Departure to Cebu 7:00 A.00 800.200.600. M.00 1.

700.700.PETTY CASH VOUCHER Department of DBP Regional Office No. Marunong City Payee/Office: GOODWILL________ _______ Address : Marunong City_____________ I.00__ Amount Refunded/(Reimbursed):____.2008________ ____Mrs. To be filled up upon liquidation Total Amount Granted: _P 4. XVI.0 -_____ C Received Refund Reimbursement Paid A Requested by: _____Mr. Ena Money_____ Petty Cash Custodian Cash Received by: __________Goodwill____________ Signature over Printed Name of Payee Date: _December 09. 2008 Responsibility Center Code: II. 2008________ .700.12 .: ___4.Ena Money____ Petty Cash Custodian D Liquidation Submitted Reimbursement Received By _____Goodwill_____ Signature of Payee Date: _December 09.00___ Total Amount Paid Per OR No. Arjay Freeman_____ Name of Requestor Approved by: ______ Winda Makadiyos______ Immediate Supervisor B Paid by: _____Mrs.: 08 .00 No. To be filled up upon request Particulars Amount Emergency purchase of office supplies P 4.01 Date: December 09.

02 Date: December 11.00 No.00___ Total Amount Paid Per OR No. To be filled up upon request Particulars Amount Purchase of spare parts P 3. Ena Money_____ Petty Cash Custodian Cash Received by: ________Mr.280.280. Arjay Freeman_______ Signature over Printed Name of Payee Date: _December 11.00___ Amount Refunded/(Reimbursed): _____. 2008________ . Arjay Freeman_____ Name of Requestor Approved by: ______ Winda Makadiyos______ Immediate Supervisor B Paid by: _____Mrs.Ena Money____ Petty Cash Custodian D Liquidation Submitted Reimbursement Received By _____Best Auto Supply_____ Signature of Payee Date: _December 11.12 .: ___3. To be filled up upon liquidation Total Amount Granted: _P 3. Marunong City Payee/Office: Best Auto Supply________ ___ Address : Marunong City_____________ I.0 -_____ C Received Refund Reimbursement Paid A Requested by: _____Mr.2008________ ____Mrs.: 08 . 2008 Responsibility Center Code: II. XVI.280.PETTY CASH VOUCHER Department of DBP Regional Office No.

03 Date: December 16.Ena Money____ Petty Cash Custodian D Liquidation Submitted Reimbursement Received By _____RDL Auto Repair Shop_____ Signature of Payee Date: _December 16.: 08 .00 No.2008________ C Received Refund Reimbursement Paid ____Mrs. Arjay Freeman_______ Signature over Printed Name of Payee Date: _December 16.750.12 . XVI.00___ Amount Refunded/(Reimbursed): ______.0 -______ A Requested by: _____Mr. 2008________ .750.PETTY CASH VOUCHER Department of DBP Regional Office No.: _____3. Arjay Freeman_____ Name of Requestor Approved by: ______ Winda Makadiyos______ Immediate Supervisor B Paid by: _____Mrs. 2008 Responsibility Center Code: II.750.00___ Total Amount Paid Per OR No. To be filled up upon liquidation Total Amount Granted: ___P 3. Ena Money_____ Petty Cash Custodian Cash Received by: ________Mr. To be filled up upon request Particulars Amount Repair of office vehicle P 3. Marunong City Payee/Office: RDL Auto Repair Shop_______ Address : Marunong City_____________ I.

To be filled up upon request Particulars Amount Payment of newspaper P 1.04 Date: December 30.800.: _____1.00___ Total Amount Paid Per OR No. 2008 Responsibility Center Code: II. To be filled up upon liquidation Total Amount Granted: ___P 1.12 . Arjay Freeman_____ Name of Requestor Approved by: ______ Winda Makadiyos______ Immediate Supervisor B Paid by: _____Mrs.00___ Amount Refunded/(Reimbursed): ______. Marunong City Payee/Office: Larry’s News Stand________ __ Address : Marunong City_____________ I.800.Ena Money____ Petty Cash Custodian D Liquidation Submitted Reimbursement Received By ____Larry News Stand____ Signature of Payee Date: _December 30. XVI. 2008________ .2008________ C Received Refund Reimbursement Paid ____Mrs.800. Ena Money_____ Petty Cash Custodian Cash Received by: ________Mr.: 08 . Arjay Freeman_______ Signature over Printed Name of Payee Date: _December 30.0 -______ A Requested by: _____Mr.00 No.PETTY CASH VOUCHER Department of DBP Regional Office No.

2008__ Date .: _____1_____ Particulars Amount P 4.) Mrs. 08-12-01 08-12-02 08-12-03 08-12-04 Report No.PETTY CASH REPLENISHMENT REPORT Department of DBP Regional Office No. 2008 __ Date 12-09-08 12-11-08 12-16-08 12-30-08 Petty Cash Voucher No.700 3.30. __(Sgd.: _08-12-01__ Sheet No.800 00 00 00 00 Emergency purchase of office supplies Purchase of spare parts Repair of office vehicles Payment of newspaper CERTIFICATION I hereby certify to the correctness of the above information. Marunong City Period Covered: December 1. Ena Money__ Petty Cash Custodian __December 31. XVI.280 3.750 1.

000.000. of Checks From Dec.000.000.00 30.000.00 11.530.300.00 17.000.00 60.00 122.00 1.000.00 51.00 115.523.900.000.000.00 4.000.00 17.00 180.510.00 723 4.00 60.000.00 412 SUNDRY 413 Acct.500.000.000.00 15.00 15.00 500.00 115.300.364.00 30.000.CHECK DISBUSEMENT JOURNAL Department of DBP.00 26.600.00 3. Code P Amount 104 20. Code 172 423 157 766 207 401 767 167 151 423 768 769 773 17.00 12.000.000.00 20.000.300.000.00 4.00 51.00 12.000.00 180.00 13.00 11.400.00 4.000.00 13.00 40.000.000.000.460.500.500.00 721 3.00 20. 4 002 08-12-01 3200101 Sheet No.00 500.00 3.510.900.460.00 10.000.00 26. ________________ DEBIT CREDIT Name of the Disbursing Officer Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money Ena Money SUNDRY 106 20.530.00 4.000.00 40.000.00 160.00 3.00 CASH DISBUSEMENT JOURNAL .00 180.00 722 751 814 989 991 20.400.000.600.400.000. Serial No.00 1.000.00 40.00 10.00 1.000. RCI/DV No.00 1.000. XVI December 2008 Date JEV No.00 Acct.000.000.Regional Office NO.300.00 160.00 4.00 180.000.000.00 P Amount To 8 11 13 17 18 20 20 23 23 26 26 27 27 27 30 30 30 30 30 30 30 30 30 30 003 004 006 008 009 012 013 014 015 016 018 019 020 021 022 023 024 025 026 027 028 029 030 031 08-12-02 08-12-03 08-12-04 08-12-05 08-12-06 08-12-07 08-12-08 08-12-09 08-12-10 08-12-11 08-12-12 08-12-13 08-12-14 08-12-15 08-12-16 08-12-17 08-12-18 08-12-19 18-12-20 08-12-21 08-12-22 08-12-23 08-12-24 08-12-25 3200102 3200103 3200104 3200105 3200106 3200107 3200108 3200109 3200110 3200111 3200112 3200113 3200114 3200115 3200116 3200117 3200118 3200119 3200120 3200121 3200122 3200123 3200124 3200125 40.

000. Code P Amount 423 180.00 SUNDRY Acct.00 180.300.00 360.Department of DBP. _______ DEBIT CREDIT SUNDRY Acct.Regional Office NO. Name of the Disbursing Officer 106 Dec 11 26 Sheet No.00 . RD No.00 180.300. XVI December 2008 Date JEV No.000. Code P Amount 005 017 Ena Money Ena Money 180.300.00 360.300.

Sign up to vote on this title
UsefulNot useful

Master Your Semester with Scribd & The New York Times

Special offer for students: Only $4.99/month.

Master Your Semester with a Special Offer from Scribd & The New York Times

Cancel anytime.