Republic of the Philippines

PROVINCIAL GOVERNMENT OF SOUTHERN LEYTE

Maasin City, Southern Leyte
OBLIGATION REQUEST No.
Payee Gamboa Et All… Date: October 17, 2022
STAFF
Address Provincial Capitol, Asuncion, Maasin City
Responsibility Account
Particulars F.P.P. Amount
Center Code
1011
To PAYMENT for Overtine and night pay 5-01-02-030
in the amount of… P 10,238.68

TOTAL>>>> P 10,238.68
A. Certified B.
Charges to appropriation necessary, lawful
and under my direct supervision Existence of available appropriation
Supporting document valid, proper and legal
Signature
Printe
d
Printed Name DANILO L. ATIENZA
Nam SYLVIA E. TORREDES
PDRRMO HEAD OF OFFICE e Prov'l Budget Officer
Position
Head, Requesting Office/Authorized Representative Head, Budget Unit/Authorized Representative
Date Date

Republic of the Philippines

PROVINCIAL GOVERNMENT OF SOUTHERN LEYTE
Maasin City, Southern Leyte

OBLIGATION REQUEST No.

Payee Gamboa Et All… Date: October 17, 2022
STAFF
Address Provincial Capitol, Asuncion, Maasin City
Responsibility Account
Center Particulars F.P.P. Code Amount
1011
To PAYMENT for Overtine and night pay 5-01-02-030
in the amount of… P 10,238.68

TOTAL>>>> P 10,238.68
A. Certified B.
Charges to appropriation necessary, lawful
and under my direct supervision Existence of available appropriation
Supporting document valid, proper and legal
Signature Printe
d
Printed Name DANILO L. ATIENZA
Nam SYLVIA E. TORREDES
PDRRMO HEAD OF OFFICE e Prov'l Budget Officer
Position
Head, Requesting Office/Authorized Representative Head, Budget Unit/Authorized Representative
Date Date
Date Date
4COPIES
 PROVINCIAL DISASTER RISK REDUCTION & MANAGEMENT OVERTIME PAYROLL

We hereby acknowledge to have received from ROSA BELLA O. DUBLAN, OIC -Treasurer of the PROVINCE OF SOUTHERN LEYTE the sums herein specified opposite our
respective names, the same, being full compensation for our services rendered during the period stated below, to the correctness of which we hereby severally certify.

PERIOD OF MONTHLY NO. OF HRS TOTAL WITH- TOTAL NET SIGNATURE WITNESS TO
NO NAME Employee ID No. DESIGNATION SERVICE RATE OVERTIME AMOUNT HOLDING DEDUCT- PAY OF MARK OR LBP Account
Number
from September OF PAY Week Sat/Sun TAX IONS PAYEE ILLEGIBLE
1-31, 2022 days Holidays SIGNATURE

1 Gamboa, Caesar A. SL160101GM Asst. LDRRMO 1-30 16,426.00 16 8 2,986.55 2,986.55 0947030329

2 Gido, Melvin P. SL160101GN Admin. Assistant I 1-30 15,461.00 29 3,821.33 3,821.33 0947030310

3 Pero, Isidro L. SL00090100 Metal worker 1 1-30 13,569.00 14 18 3,430.80 3,430.80 0946116262

- -

TOTAL 10,238.68 - - 10,238.68

CERTIFIED: Services have been duly rendered as stated APPROVED FOR PAYMENT:

DANILO L. ATIENZA DAMIAN G. MERCADO

PDRRMO Provincial Governor

CERTIFIED: Funds available in the amount of 10,238.68 CERTIFIED: Each employee whose name
indicated opposite his/her name

ROSA BELLA O. DUBLAN ___________________________________

OIC - Provincial Treasurer Disbursing Officer
emp gross tax slem iphemco cfi
SL160101GM 2986.55
SL160101GN 3821.33
SL00090100 3430.80