LIST OF DUE & DEMANDABLE ACCOUNTS PAYABLE - ADVICE TO DEBIT ACCOUNT (LDDAP - ADA)

DEPARTMENT:
AGENCY:
FUND CODE:
MDS-GSB/MDS ACCOUNT NO.:
NCA No.:

I. LIST OF DUE AND DEMANDABLE ACCOUNTS PAYABLE (LDDAP)

CREDITOR ALLOTMENT In Pesos
NO. PREFERRED SERVICING BANK/ OBLIGATION CLASS GROSS WITHHOLDING NET REMARKS
NAME
SAVINGS/CURRENT ACCNT NO. REQUEST NO. (per UACS) AMOUNT TAX AMOUNT
I. CURRENT YEAR A/Ps
1 Bureau of the Treasury - Fidelity Bond LBP Clearing - -
Fund Account -
110050300011 3402-2851-59
NCO - LD9999 - -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
SubTotal - - -
II. PRIOR YEAR'S A/Ps
- -
- -
- -
SubTotal - - -

GRAND TOTAL - - -

I hereby warrant that the above List of Due and Demandable I hereby assume full responsibility for the veracity and accuracy
Accounts Payable was prepared in accordance with existing of the listed claims, and the authenticity of the supporting documents
budgeting, accounting and auditing rules and regulations. as submitted by the claimants.

Certifed Correct: Approved:

Accountant II Regional Director

II. ADVICE TO DEBIT ACCOUNT (ADA)
To: MDS GSB of the Agency:

Please debit the MDS Sub-Account Number:

Please credit the accounts of the above listed creditors to cover payments of Accounts Payable (A/Ps).

TOTAL AMOUNT : -
(in words)

Agency Authorized Signatories:

Administrative Officer III Regional Director

(Erasures shall invalidate this document)

FOR MDS-GSB USE ONLY:
Instructions:
1 Agency shall arrance the creditors on a "first-in, first-out" basis, that is, according to the date of receipt of supplier's/creditor's
billing, duly supported with complete documents.
2 MDS-GSB branch concerned shall indicated under 'Remarks' column, non-payments made to concerned creditors due to
inconsistency in information (creditor account name, number) between LDDAP-ADA and bank records.
NOTE: LDDAP-ADA NO:
The LDDAP-ADA is an accountable form. Date of Issue:
 Annex A

DEPARTMENT:
AGENCY: SLIIE No.
OPERATING UNIT:
FUND CODE:

Summary of LDDAP - ADAs Issued and Invalidated ADA Entries (SLIIE)

To: The Bank Manager

LBP Bajada Branch
JP Laurel Ave., Bajada, Davao City

Amount For GSB Use Only

LDDAP - ADA No. Date of Isssue Allotment / Object Class
Total Remarks
PS MOOE CO FINEX

1 -

-
Total Amount: -
No. of pcs. Of LDDAP - ADA: 1
Amount in Words: Twelve Thousand Two Hundred One & 08/100 Pesos Only.

OF WHICH INVALIDATED ENTRIES OF PREVIOUSLY ISSUED LDDAP - ADAs For GSB Use Only
LDDAP - ADA No. Amount Date Issued Allotment / Object Class
Remarks
PS MOOE CO FINEX TOTAL

- -

Certified Correct by: Approved by:

Accountant II Regional Director

TRANSMITTAL INFORMATION

Delivered by: Received by: