Annex A

Republic of the Phillippines

PHILIPPINE ECONOMIC ZONE AUTHORITY
Roxas Boulevard, Pasay City
No.
BUDGET UTILIZATION REQUEST
Payee

Office

Address
Responsibility Account
Particulars Amount
Center Code

Total
A. Certified B. Certified
Charges to budget necessary, lawful and under Budget available and earmarked/utilized for the
my direct supervision purpose as indicated above
Supporting documents valid, proper and legal

Signature Signature
Printed
Printed Name
Name

Position Position
Head, Requesting Office/Authorized Representative Head, Budget Unit/Authorized Representative

Date Date
 BUDGET UTILIZATION REQUEST (BUR)
INSTRUCTIONS
A. The BUR shall be prepared in three copies to be
distributed as follows:
Original – to be attached to the DV
Duplicate – Budget Unit
Triplicate – Accounting Unit
B. The Budget Unit shall stamp the date of receipt
on the face of this form.
C. This form shall be accomplished in the
following manner:
1. No. – number assigned to the BUR by the
Budget Section/Unit and date of preparation.
The numbering shall be as follows:
00 0000 00 0000
Serial number (one series for
each year)
Month
Year
Budget Classification
2. Payee – name of the payee/creditor
3. Office – office of the payee/creditor
4. Address – address of the payee/creditor
5. Responsibility Center – code of the cost
center where expenses shall be charged
6. Particulars -- brief description of the charges
7. Account Code -- expense/ asset/ liability
account code where the utilization shall be
charged
8. Amount – amount of budget utilization/
adjustment
9. Certified (Box A) – Certification by the
Head of the Requesting Unit or his
authorized representative on the necessity
and legality of charges to the budget under
his supervision, and validity, propriety and
legality of supporting documents
The certifying officer shall affix his
signature, indicate his printed name, position
and the date of his signing on the spaces
provided.
10. Certified (Box B) – Certification by the
Head of the Budget Unit or his authorized
representative on the availability of budget
earmarked/utilized for the purpose indicated
therein
The certifying officer shall affix his
signature, indicate his printed name, position
and the date of his signing on the spaces
provided.
D. Any correction/adjustment by the Accounting
Unit which will require the corresponding
adjustment on budget utilization shall be
coordinated with the Budget Unit.
BACK
 Annex B

Republic of the Philippines

PHILIPPINE ECONOMIC ZONE AUTHORITY
Roxas Boulevard, Pasay City
No.
DISBURSEMENT VOUCHER
Mode of
Check Cash Others
Payment
TIN/Employee No. BUR No.
Payee

Responsibility Center
Office/Unit/Project Code
Address

EXPLANATION AMOUNT

A. Certified B. Approved for Payment

Supporting documents complete

Signature Signature

Printed Printed
Name Name

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
C. Received Payment JEV No.
Date Bank Name
Check No.

Date Printed Name Date

Signature

OR/Other Documents
 DISBURSEMENT VOUCHER (DV)
INSTRUCTIONS
A. The DV shall be printed in one whole sheet of
81/2 x 11 size bond paper. This shall be prepared
in three copies to be distributed as follows:
Original – Accounting Unit
Duplicate – Cash Unit
Triplicate – Payee
B. The Accounting Unit shall stamp the date of
receipt on the face of this form.
C. This form shall be accomplished in the following
manner:
1. DV No./Date – number assigned to the DV
by the Accounting Unit and the date of DV
preparation. It shall be numbered as follows:
0000 00 0000
Serial number
(one series each year )
Month
Year
2. Mode of Payment – put a check "√" mark in
the appropriate box opposite the mode of
payment
3. Payee – name of the payee/creditor
4. TIN/Employee No. – Tax Identification
Number (TIN) of the claimant/Identification
Number assigned by the agency to the
officer/employee
5. BUR No. – Number of the Budget Utilization
Request supporting the DV
6. Address – address of the claimant
7. Responsibility Center (Office/Unit/Project
and Code) – the office/unit/project and code
assigned to the cost center where the
disbursement shall be charged
BACK
10. Explanation – brief description of the
disbursement
11. Amount – amount of claim
12. Certified (Box A) – certification by the Head
of Accounting Unit or his authorized
representative as to completeness of
supporting documents.
The certifying officer shall affix his
signature, print his name, indicate his
position, and the date of his signing on the
spaces provided.
13. Approved for Payment (Box B) – approval
by the Head of the Agency or his Authorized
Representative on the payment covered by
the DV.
The approving officer shall affix his
signature, print his name, indicate his
position, and the date of his signing on the
spaces provided.
14. Received Payment (Box C) –
acknowledgment by the claimant or his duly
authorized representative for the receipt of
the check/cash and the date of receipt. The
claimant/payee shall affix his signature on
the space provided and shall indicate the
number and the date of the check, bank name
and number and date of OR/other relevant
documents issued to acknowledge the receipt
of payment
15. JEV No. and Date – Number and date of the
Journal Entry Voucher
SAMPLE
Annex C
Republic of the Philippines
PHILIPPINE ECONOMIC ZONE AUTHORITY
Registry of Budget and Utilization (RBU)
________________________________
Calendar Year
Expense Class : ___________
Sheet No. : ___________
Account Approved Budget Cumulative Budget Utilization Cumulative Utilization Balance
Date Reference
Code (A) (B) (C) (D) (B-D)
 REGISTRY OF BUDGET AND UTILIZATION
____________________________________
(RBU)
INSTRUCTIONS

A. The RBU shall be maintained by Expense Class – RBUPS for Personal Services,
RBUMO for Maintenance and Other Operating Expenses, RBUCO for Capital
Outlay and RBUFE for Financial Expenses

B. This shall be accomplished as follows:

1. Sheet No. – sheet number which shall be one series for each year
2. Date – date of the Approved Budget/Budget Utilization Request (BUR)
3. Reference – Approved Budget/BUR number
4. Account Code – account code where the utilization shall be charged as shown
in the BUR
5. Approved Budget – amount of approved budget
6. Cumulative Budget – amount of approved budget and any supplemental/
additional budget as of a given date
7. Utilization – amount of utilized budget/commitment made based on the
approved BUR supported by pertinent documents
8. Cumulative Utilization – the cumulative amount of utilization as of a given
date
9. Balance – budget available for utilization

C. This Registry shall be maintained to control the budget. Unless authorized, the
amount of utilization should not exceed the available budget.

D. At year-end, unless authorized, the unutilized budget in the RBU shall be closed. No
BUR is needed as the available budget will automatically lapse.

E. In case a balance in budget exists in the RBU, a negative entry shall be made on the
Cumulative Budget column to arrive at a zero balance.

BACK
 Annex D

REPUBLIC OF THE PHILIPPINES

PHILIPPINE ECONOMIC ZONE AUTHORITY
DAILY CASH POSITION REPORT
As of _______________

Collections:
Permit and Licenses P xxx
Service Income xxx
Business Income xxx
Subsidy Income xxx
Other General Income xxx
Total Collections P xxx
Less: Disbursements
Personal Services xxx
Maintenance and Other Operating Expenses xxx
Capital Outlay xxx
Financial Expenses xxx
Total Disbursements P xxx
Net Cash for the day xxx
Add: Cash, Beginning Balance xxx
Total Cash Available todate P xxx

Certified Correct:

__________________________________________
Head, Treasury Unit/Authorized Representative
__________________________________________
Date