Republic of the Philippines Republic of the Philippines

Department of Finance Department of Finance

BUREAU OF TREASURY - A5514 BUREAU OF TREASURY - A5514
Office of the District/Chief Treasury Operations Officer II Office of the District/Chief Treasury Operations Officer II
EASTERN SAMAR EASTERN SAMAR
Address Address
To : THE MANAGER ATAP NO. 0826-2024-0839 To : THE MANAGER ATAP NO. 0826-2024-0839
LBP/DBP LBP/DBP
BORONGAN/GUIUAN BORONGAN/GUIUAN

A U T H O R I T Y TO A C C E P T P A Y M E N T A U T H O R I T Y TO A C C E P T P A Y M E N T
FOR DEPOSIT TO SAVINGS ACCOUNT OF THE TREASURER OF THE PHILIPPINES FOR DEPOSIT TO SAVINGS ACCOUNT OF THE TREASURER OF THE PHILIPPINES

PAYING AGENCY BUREAU OF THE TREASURY AREA CODE 0826 PAYING AGENCY BUREAU OF THE TREASURY AREA CODE 0826

PAYING AGENCY CODE A5514 DATE PREPARED 4/3/2024 PAYING AGENCY CODE A5514 DATE PREPARED 4/3/2024
ADDRESS BILL NO. (YR-MONTH-NUMBER) ADDRESS BILL NO. (YR-MONTH-NUMBER)
SK-Brgy. Hollywood, Guiuan SK-Brgy. Hollywood, Guiuan

COMPUTATION OF FIDELITY BOND PREMIUM DUE COMPUTATION OF FIDELITY BOND PREMIUM DUE
FUND TRANSACTION AMOUNT OF BOND FUND TRANSACTION AMOUNT OF BOND
AMOUNT AMOUNT
CODE CODE (at 1.5% per annum / P 150.00) CODE CODE (at 1.5% per annum / P 150.00)

152 663 P 69,500.00 P 1,042.50 152 663 P 69,500.00 P 1,042.50

THIS ATAP IS VALID UNTIL APRIL 25, 2024 ONLY THIS ATAP IS VALID UNTIL APRIL 25, 2024 ONLY

TOTAL AMOUNT PAYABLE P 1,042.50 TOTAL AMOUNT PAYABLE P 1,042.50

PREPARED BY: APPROVED BY: PREPARED BY: APPROVED BY:

ARJAY D. LOSO BIENVENIDO F. LACABA JR. ARJAY D. LOSO BIENVENIDO F. LACABA JR.
TROO IV OIC PROVINCIAL HEAD TROO IV OIC PROVINCIAL HEAD
Signature Over Signature Over Signature Over Signature Over
Printed Name and Position Printed Name and Position Printed Name and Position Printed Name and Position

FOR BANK'S USE ONLY FOR BANK'S USE ONLY

DETAILS OF PAYMENT DETAILS OF PAYMENT
DRAWEE BANK / NUMBER PARTICULARS DRAWEE BANK / NUMBER

CASH P CASH P

CHECK CHECK

TOTAL PAYMENT RECEIVED P TOTAL PAYMENT RECEIVED P

BANK MACHINE VALIDATION OF AMOUNT AND DATE BANK MACHINE VALIDATION OF AMOUNT AND DATE