Republic of the Philippines

Department of Finance
BUREAU OF TREASURY - A5514
Office of the District/Chief Treasury Operations Officer II
Region V - Bicol
Address

To: THE BRANCH MANAGER ATAP NO. 0516-2023-01224

LAND BANK OF THE PHILIPPINES
DAET F. PIMENTEL, CAMARINES NORTE (UCPB)

AUTHORITY TO ACCEPT PAYMENT

FOR DEPOSIT TO SAVINGS ACCOUNT OF THE TREASURER OF THE PHILIPPINES
PAYING ORGANIZATION AREA CODE 0516
DEPARTMENT OF EDUCATION (DEPED) - OFFICE OF THE SECRETARY
PAYING ORGANIZATION CODE 07 001 DATE PREPARED 11/07/2023
ADDRESS DEPED - FLORENCE ES, STA. ELENA, CAMARINES NORTE BILL NO. (YR-MONTH-NUMBER)
(SP I) B-0516-202311-1224
COMPUTATION OF FIDELITY BOND PREMIUM DUE
AMOUNT BOND
FUND CODE TRANSACTION CODE AMOUNT
(at 1.5% per annum / P 150.00)
03104344 4020219000 75,000.00 1,125.00

TOTAL AMOUNT PAYABLE 1,125.00

PREPARED BY: Digitally signed by APPROVED BY: Digitally signed by Dela
Laureles Richard Gene Roca Oliva Garcillanosa
Torero
Date: 2023.11.06
Date: 2023.11.06
15:36:31 +08'00' 15:37:00 +08'00'
RICHARD GENE T. LAURELES OLIVA A. GARCILLANOSA - DELA ROCA
TROO III TROO IV / OIC
Signature Over Signature Over
Printed Name and Position Printed Name and Position

FOR BANK USE ONLY

DETAILS OF PAYMENT
PARTICULARS DRAWEE BANK / NUMBER
CASH P
CHECK
TOTAL PAYMENT RECEIVED P
BANK MACHINE VALIDATION OF AMOUNT AND DATE