Appendix 1

DV No.
Date:
DISBURSEMENT VOUCHER
Barangay: Lamhaku City/Municipality: TBOLI
Tel No. Province: South Cotabato

Payee/ Officer: DOLORES M. BERNASOL Employee No:

TIN No:
Particulars Amount

Cash Advance payment for Materials, perimeter fence, as per

supporting paper hereto attached in the total amount of…………………… P29,959.00

Less 4% WITHOLDING TAX……………………………………………. P1,198.00

TOTAL P 28,760.00
A. Certified: B. Certified: C. Certified:
Existence of Available appropriations for Funds(cash)Available As to Validity, Propriety ,and Legality
The charges/expenses indicated above Approved:
For payment
SIGNATURE:___________________ SIGNATURE:____________________ SIGNATURE:____________________
PRINTED NAME: MELVIN M. BUNGAN PRINTED NAME:ANALYN G. LUMBAY PRINTED NAME: KOSOL A. MINDING
POSITION: Chair. Comm. On Appropriations POSITION: Barangay Treasurer POSITION: Punong Barangay
DATE: _________________ DATE:_______________ DATE:_____________

D. Received Payment:

Check No.
Date:
Signature over printed name Bank Name: LBP/ Surallah
Date:__________________ OR Number:_________ Date

17
 Appendix 1

LIQUIDATION REPORT

Barangay ___________LAMHAKU________________ City/Municipality: ____TBOLI________ LR No._____________

Accountable Officer: __ANALYN G. LUMBAY______ Province : ___SOUTH COTABATO_____ Date: __

Particulars Amount

P
TOTAL AMOUNT SPENT P
AMOUNT OF CASH ADVANCE PER DV NO. ____________DTD________
AMOUNT (REFUNDED) PER DV NO.__________________DTD________
A. Prepared by: B. Certified: Supporting Documents C. Approved by:
Existence of Available appropriations
for the charges/expenses indicated
above
Signature:______________________
_ Signature:____________________ Signature: ____________________
Printed Name: ANALYN G. LUMBAY_ Printed Name: _MERCEDEZ B. SMAN Printed Name: KOSOL A. MINDING
Position: Barangay Treasurer Position: Barangay Record Keeper Position: Barangay Captain
Date: _________________ Date:_________________ Date: __________________

D. Refund made:
_______________________________
Accountable Officer

Refund Received: _____________________________

Reimbursement made: _________________________

71
 Appendix 1

DV No.
Date:
DISBURSEMENT VOUCHER
Barangay: Lamhaku City/Municipality: TBOLI
Tel No. Province: South Cotabato

Payee/ Officer: MERCEDEZ B. SMAN Employee No:

TIN No: Fund:
Particulars Amount

TOTAL P
A. Certified: B. Certified: C. Certified:
Existence of Available appropriations for Funds(cash)Available As to Validity, Propriety ,and Legality
The charges/expenses indicated above Approved:
For payment
SIGNATURE:___________________ SIGNATURE:____________________ SIGNATURE:____________________
PRINTED NAME: MAT L. DASAN PRINTED NAME:MERCEDEZ B. SMAN PRINTED ANME: KOSOL A. MINDING
POSITON: Chair. Comm. On Appropriations POSITION: Barangay Treasurer POSITION: Punong Barangay
DATE: _________________ DATE:_______________ DATE:_____________

D. Received Payment:

Check No. Date

Signature over printed name Bank Name: LBP/ Surallah
Date:__________________ OR Number:___________ Date

17