DISBURSEMENT VOUCHER DV No.

_________
Date: _________

Barangay: BALOGO SK City / Municipality: OAS

Tel. No.:
Province : ALBAY

TIN/Employee No. Fund:

Payee SK Fund

Address
PARTICULARS AMOUNT

A. Certified B. Certified Certified:

As to validity, property, and legality of
Allotment Obligated for the Funds Available fund:
purpose as indicated above Approved:
Supporting documents For Payment:
complete :
Signature Signature Signatur
e
Printed Printed
Name LIEZET R. DE LEON Name MA. GLADYS B. HIPOLITO Printed ANDRIA D. MIRABUENO
Name
Budget Monitoring SK CHAIRMAN
Position Officer Position SK Treasurer Position
Date:
D.: Received Payment:

Check No. ____________ Date: __________

Signature Over Printed Bank Name: LBP Ligao City
Date: ____________________ OP Number: ______________ Date: