Annex (“A”)

SK of Barangay Poblacion
Municipality of Dasol
Province of Pangasinan

SK CHAIRPERSON’S CERTIFICATION

SKTCC NO.: ___________________________

Date: _______________________________

To: The Bank Manager

Land Bank of the Philippines
Alaminos Branch

Sir/Madam:

This is to certify that the following checks were duly issued by SK of Barangay
POBLACION, complete with respective Disbursement Vouchers and Supporting documents.

Account No. Check No. Date Payee Amount Purpose

This Certification is issued, pursuant to COA Circular 2019-001, dated 01-30-19 as a

condition for the encashment of said checks.

The undersigned attests to the truthfulness of the foregoing facts, under pain of
liability for falsification, pursuant to Article 171(4) of the Revised Penal Code.

Very Truly Yours,

CANDICE JEAN B. MANCHING

SK Chairperson

Delivered By: Received By:

ROJENTHS T. SALVADOR
SK Treasurer BANK REPRESENTATIVE

Date: ____________________ Date: ____________________