Professional Documents
Culture Documents
SYSTEM
RECORDS:
CE RT IF ICAT ION
I hereby certify that the foregoing is a correct and complete record of all checks issued by me in my capacity as Position of Name of School, during the period
from Period Covered inclusives, as indicated in the corresponding columns.
Period Covered:
Report No.:
Bank Name/Account No: DBP - AccountNumber Sheet No.:
GRAND TOTAL -
CERTIFICATION
I hereby certify that this Report of Checks Issued in one (1) sheet(s) is a full, true and correct statement of all
checks released by me in payment for obligations for the period stated and shown in the attached
disbursement vouchers.
Period Covered:
Appendix 65
Beginning Balance Receipt Issued Ending Balance
Name of Form & No. Inclusive Serial Nos. Inclusive Serial Nos. Inclusive Serial Nos. Inclusive Serial Nos.
Qty. From To Qty. From To Qty From To Qty From To
Commercial Check 1 1 0 1 0
Account Number
GRAND TOTAL 1 1 0
Certification
I hereby certify that the foregoing is a true statement of all accountable form s received, issued and transferred by me during
the period above-cited and the correctness of the beginning balances.
Accountable Officer
Position
Liquidation Report (LR)
Appendix 44
PARTICULARS AM OUNT
ADA #:
Amount: