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Appendix 44

LIQUIDATION REPORT Serial No.: _________________


Period Covered Date: _____________________

Entity Name : Canlampay ES, CARIGARA 1II DISTRICT Responsibility Center Code:
Fund Cluster : 01-REGULAR __________________________

PARTICULARS AMOUNT

To liquidate cash advance of school with 64,695.78


ADA # M dated , 2022 in the
amount of . . . . . .

TOTAL AMOUNT SPENT 36,282.62


AMOUNT OF CASH ADVANCE PER DV NO.______DTD. ______ 64,695.78
AMOUNT REFUNDED PER OR NO. ________DTD. ___________
AMOUNT TO BE REIMBURSED
A Certified: Correctness of the B Certified: Purpose of travel / C Certified: Supporting
above data cash advance duly accomplished documents complete and proper

MARIA JULIANA P. FAMI EMERITO S. GAVIOLA,EdD. MECHELLE G. SAMSON


Signature over Printed Name Signature over Printed Name Signature over Printed Name
Claimant District Supervisor Senior Bookkeeper

JEV No.: ___________________

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