Republic of the Philippines

Department of Education
Region IV-A
SCHOOLS DIVISION OF QUEZON PROVINCE
DISTRICT: ________________ SCHOOL: _______________________________________ DATE: _____________

Please be informed that the following documentary requirements are arranged and attached accordingly for the
claim of SECURITY EXPENSE included in the Liquidation Report for the month of ____________, _______ submitted to the
Accounting Section of the Division Office. (Month) (Year)

 Disbursement Voucher
 Photocopy of Check Issued
 Contract
 License/ Permit to Operate from Camp Crame
 Daily Time Record (DTR)
 Billing Statement from Security Agency
 Official Receipt (OR)
 Community Tax Certificate (CTC) of Security Guard
 Business Permit/Certificate of Registration/DTI Registration

Certified by:

DEPEDQUEZON-TM-SDS-04-025-003

“Creating Possibilities, Inspiring Innovations”

Address: Sitio Fori, Brgy. Talipan, Pagbilao, Quezon
Trunkline #: (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321
Email Address:quezon@deped.gov.ph
Website: www.depedquezon.com.ph

--------------------------------------------------------------------------------------------------------------------------------------------------------------
(To be accomplished by accounting personnel)

DISTRICT: ______________________SCHOOL: ____________________________________________________PERIOD COVERED: _____________________

Sir/Ma’am:

Based on the submitted documents for the claim, the following are the findings which shall complied before the deadline to be liquidated:

 Please arrange/attached the forms properly based on the checklist

 Please attach copy of check issued.
 DISBURSEMENT VOUCHER
 Incomplete fill out: date/s; series number; name; check number  Wrong Accounting Entry
 No Signature on BOX A / BOX B  Miscomputation
 Others: ___________________________________________________________________________________________________________________
 CONTRACT
 Expired contract  Others: _______________________________________________________________________________________________
 LICENSE/PERMIT TO OPERATE:
 Expired License  Others: _______________________________________________________________________________________________
 DAILY TIME RECORD
 Incomplete fill out: month; year; name  No Signature/s  Others: ___________________________________________________
 BILLING STATEMENT FROM AGENCY:
 Attach copy  Others: _____________________________________________________________________________
 OFFICIAL RECEIPT:
 Attach original copy  No date  No Signature  Others: ___________________________________________________
 COMMUNITY TAX CERTIFICATE:
______________________________________________________________________________________________________________________________
 BUSINESS PERMITS:
______________________________________________________________________________________________________________________________
 OTHERS:______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
THANK YOU.
 Republic of the Philippines
Department of Education
Region IV-A
SCHOOLS DIVISION OF QUEZON PROVINCE
____________________________________
Signature over printed name of School Head

DEPEDQUEZON-TM-SDS-04-025-003

“Creating Possibilities, Inspiring Innovations”

Address: Sitio Fori, Brgy. Talipan, Pagbilao, Quezon
Trunkline #: (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321
Email Address:quezon@deped.gov.ph
Website: www.depedquezon.com.ph

--------------------------------------------------------------------------------------------------------------------------------------------------------------
(To be accomplished by accounting personnel)

DISTRICT: ______________________SCHOOL: ____________________________________________________PERIOD COVERED: _____________________

Sir/Ma’am:

Based on the submitted documents for the claim, the following are the findings which shall complied before the deadline to be liquidated:

 Please arrange/attached the forms properly based on the checklist

 Please attach copy of check issued.
 DISBURSEMENT VOUCHER
 Incomplete fill out: date/s; series number; name; check number  Wrong Accounting Entry
 No Signature on BOX A / BOX B  Miscomputation
 Others: ___________________________________________________________________________________________________________________
 CONTRACT
 Expired contract  Others: _______________________________________________________________________________________________
 LICENSE/PERMIT TO OPERATE:
 Expired License  Others: _______________________________________________________________________________________________
 DAILY TIME RECORD
 Incomplete fill out: month; year; name  No Signature/s  Others: ___________________________________________________
 BILLING STATEMENT FROM AGENCY:
 Attach copy  Others: _____________________________________________________________________________
 OFFICIAL RECEIPT:
 Attach original copy  No date  No Signature  Others: ___________________________________________________
 COMMUNITY TAX CERTIFICATE:
______________________________________________________________________________________________________________________________
 BUSINESS PERMITS:
______________________________________________________________________________________________________________________________
 OTHERS:______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
THANK YOU.