Disbursement Voucher DV No:

Barangay: POBLACION City/Municipality: STLU Date:

Payee: Province: LA UNION Fund:

Address: TIN:
Particulars Amount

A.Certified as to existence of B.Certified as to availability of funds for C.Certified as to validity,

appropriation for obligation the purpose, and completeness and propriety, and legality of
propriety of supporting documents claim and approved for
payment

____________________________ _______________________________ _____________________

ALAIN P. ALAMBRA SHEILO REGINA D. ABORDO EMMANUEL A. AVERION
Chairman, Committee on Appropriation Barangay Treasurer PUNONG BARANGAY

D.Received Payment
Check No.: _________________
Bank Name: LBP- AGOO_______
OR No.:
E. Accounting Entries
Account Account Code Debi Credit
t

Prepared by:

AERIANE R. LACHICA ANN LORAINE C. TUMAGCAO

Barangay Bookkeeper Date Municipal Accountant Date