Republic of the Philippines

Province of Eastern Samar

Municipality of Dolores
Barangay 07 Poblacion

SANGGUNIANG KABATAAN CERTIFICATION (SKC)

SKC No.: 001

DATE:
To: The Bank Manager
Development Bank of the Philippines
Dolores, Eastern Samar

Sir/Madam:

This is to certify that the hereunder listed checks, with details of payee, amount and date of check were
issued by Barangay 07 Poblacion complete with respective Disbursement Vouchers and supporting document.

Account No. Check No. Date Payee Amount Purpose

0-193-757-074 0090891101 03-22-2024 BEVERLY R. RIVERA 16,000.00 Honorarium
January-March
0-193-757-074 0090891102 03-22-2024 BEVERLY R. RIVERA 40,000.00 Summer Sports Tournament
Prizes

TOTAL 56,000.00

This Certification is Issued, pursuant to COA Circular 2019-001, dated January 30, 2019 as condition for the
Encashment of the said checks.
The undersigned attests to the truthfulness of the foregoing facts under pain of liability for falsification, pursuant to
Article 17(4) of the Revised Penal Code.

Very truly yours,

BEVERLY R. RIVERA
SK Chairperson

Delivered by: Received by:

_ANTHONY M. ALCIDO_ .
SK Treasurer/Representative Bank Representative
Date: ________________ Date: ________________