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General Form No.

74(A)
Revised Dec. 22, 1983 COMMISSION
REPORT OF CASH
Name of Accountable Officer: EVELYN S. RAO
Agency: Department of Agrarian Reform - Provincial Office, South Cotabato
Minimum Cash Accountability Amount of Bond:
P225,000.00
AUDITOR/EXAMINER
DANILO C. CABIDOG/ABRAHAM U. MAGNO
A. C A S H P R O D U C T I O N
TO: Accountable Officer: Position
EVELYN S. RAO Assistant S

Demand is hereby made that you produce all your cash, treasury warrants, checks, money orders, cash item
you are officially accountable as Assistant Statistician/Collecting Officer of
, and any fund. treasury warrant and/or cash items in your possession held by you for deposit and safekeepin

NOTED Accountable Officer's Signature: Date:


COMPLIED November 19, 2015
WITH
INVENTORY OF CASH ON HAND INVENTO
PAPER AND COIN
DENOMI- NO. OF Date Bank Check No.
NATION PIECES AMOUNT
P 1,000.00 -
500.00 -
200.00 -
100.00 2 200.00
50.00
20.00 1 20.00
Coins
10.00
5.00 1 5.00
1.00 5 5.00
0.25 -
0.10
0.01

Total as presented P 230.00


B. TOTAL INVENTORY OF CASH AND/OR ALLOWED CASH I
C. INVENTORY OF UNUSED ACCOUNT
WITH MONEY VALUE
NAME OF
INCLUSIVE SERIAL NO.
FORM QTY. DENOMINATION AMOUNT

Total - -

I HEREBY CERTIFY on my official oath: (1) That upon demand by the Auditor/Examiner, I produced all m
paid vouchers, unused accountable forms, etc., for which I am officially accountable, (2) That the inventory o
possession were produced to the Auditor/Examiner at the time of the cash count today,
as follows:
1) Cash and/or cash items
2) Unused accountable forms with money value
3) Unused accountable forms without money value
of which (P 0.00 ) was disallowed by the Auditor/Examiner and (3) That said cash, treasury warrant
accountable forms were returned to me intact after the cash count.

Signature of Accountable Officer: Position:

EVELYN S. RAO Assistant Statistician/Colle

Signed in the
Presence of:

ANGELES R. BARRETO
Annex D
COMMISSION ON AUDIT
T OF CASH EXAMINATION
Position: Assistant Statistician/Collecting Officer
Station Koronadal City
Risk No. Effective Date:
68-15-0146R January 20, 2015
OFFICIAL DESIGNATION:
State Auditor IV/State Auditor I
D U C T I O N N O T I C E
Date
Assistant Statistician/Collecting Officer November 19, 2015

oney orders, cash items, paid vouchers, unused accountable forms , etc., in which
Department of Agrarian Reform - Provincial Office, South Cotabato
eposit and safekeeping.

Auditor/Duly Authorized Representative:

INVENTORY OF CASH ITEMS


Amount
Particulars Allowed Disallowed

Total as Presented - -
R ALLOWED CASH ITEMS (TO D) P 230.00
USED ACCOUNTABLE FORMS:
WITHOUT MONEY VALUE
NAME OF FORM QTY. INCLUSIVE SERIAL NO.

AF 51 TF (158 RA) 33 9011118 9011150


(158 NG) 31 5412620 5412650
(101-370) 24 5412427 5412450
GF (101 NG) 33 9011618 9011650
1000 1414001 1415000
MinSAAD 49 9011202 9011250

Total 1170

miner, I produced all my cash, treasury warrants, checks, money orders, cash items,
) That the inventory of such cash, cash items and unused accountable forms in my
November 19, 2015 is correctly stated above and broken down

P 230.00
- pcs.
1,170 pcs.
ash, treasury warrants, checks, money orders, cash items, paid vouchers, unused

Date:

tant Statistician/Collecting Officer December 15, 2105

JO ANN P. GUMBAO
EVELYN S. RAO Annex
Assistant Statistician/Collecting Officer
Department of Agrarian Reform - Provincial Office, South Cotabato
Koronadal City
AMOUNT OF BOND : P225,000.00
RISK NUMBER : 68-15-0146R
EFFECTIVE DATE : January 20, 2015

STATEMENT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS WITHOUT MONEY VALUE


As of November 19, 2015

BALANCES BEGINNING RECEIVED SINCE ISSUED SINCE BALANCE ON HAND PER


July 1, 2014 November 19, 2015 ACTUAL COUNT
TYPE OF FORM QTY. SERIAL NO. QTY. SERIAL NO. QTY. SERIAL NO. QTY. SERIAL NO. QTY. SERIAL NO.

AF 51
101 NG 336 9011315 9011650 303 9011315 9011617 33 9011618 9011650 33 9011618 9011650
1000 1414001 1415000 1000 1414001 1415000 1000 1414001 1415000
101 RA 34 5412417 5412450 10 5412417 5412426 24 5412427 5412450 24 5412427 5412450

158 NG 31 5412620 5412650 31 5412620 5412650 31 5412620 5412650

158 NG 43 9011108 9011150 10 9011108 9011117 33 9011118 9011150 33 9011118 9011150

MINSAAD 49 9011202 9011250 49 9011202 9011250 49 9011202 9011250

TOTAL 493 1,000 323 1,170 1,170


I HEREBY CERTIFY THAT THE HEREIN STATEMENT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS
WITHOUT MONEY VALUE AS OF November 19, 2015 IS TRUE AND CORRECT

Prepared by: Reviewed by:


ABRAHAM U. MAGNO DANILO C. CABIDOG EVELYN S. RAO
State Auditor I State Auditor IV Assistant Statistician/Collecting Officer
Date: November 19, 2015 Date: November 19, 2015 Date: November 19, 2015

EVELYN S. RAO
Assistant Statistician/Collecting Officer
Department of Agrarian Reform - Provincial Office, South Cotabato
AMOUNT OF BOND : P500,000.00
RISK NUMBER : 68-15-0146R
EFFECTIVE DATE : August 7, 2015

STATEMENT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS WITHOUT MONEY VALUE


As of September 30, 2015

BALANCES BEGINNING RECEIVED SINCE ISSUED SINCE BALANCE ON HAND PER


July 1, 2014 November 19, 2015 ACTUAL COUNT
TYPE OF FORM QTY. SERIAL NO. QTY. SERIAL NO. QTY. SERIAL NO. QTY. SERIAL NO. QTY. SERIAL NO.
Balance Forwarded 493 1,000 323 1,170 1,170
AF 51 - - -
Trust Fund 22 5189579 5189600 8 5189579 5189586 14 5189587 5189600 14 5189587 5189600

General Fund 105 5186396 5186500 105 5186396 5186500 105 5186396 5186500
400 5189601 5190000 68 5189601 5189668 332 5189669 5190000 332 5189669 5190000
TOTAL 1,020 - 504 1,516 1,621
I HEREBY CERTIFY THAT THE HEREIN STATEMENT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS
WITHOUT MONEY VALUE AS OF November 19, 2015 IS TRUE AND CORRECT

Prepared by: Reviewed by:

ABRAHAM U. MAGNO DANILO C. CABIDOG EVELYN S. RAO


State Auditor I State Auditor IV Assistant Statistician/Collecting Officer
Date: September 30, 2015 Date: September 30, 2015 Date: September 30, 2015
Annex

DIFFERENCE
QTY. SERIAL NO.

- - -

-
FOR ACCOUNTABLE FORMS
VELYN S. RAO
tistician/Collecting Officer
November 19, 2015

DIFFERENCE
QTY. SERIAL NO.

- - -
-
FOR ACCOUNTABLE FORMS

VELYN S. RAO
tistician/Collecting Officer
September 30, 2015
D. S T A T E M E N T O F A C C O U N T A B I L I T Y

CASH COLLECTIONS
NATURE OF FUNDS
ADVANCE Fund 101 NG Fund 101 RA Fund 158 NG Fund 158 RA MinSAAD
BALANCE, Last Examination: - - - - - -
Add: Debits to Accountability
July 1-31, 2014 - 4,455.00 - - - -
August 1-31, 2014 12,430.00 18,968.30 - 40,000.00 -
September 1-30, 2014 4,715.00 - - - -
October 1-31, 2014 - 3,845.00 17,936.60 - 15,000.00 -
November 1-30, 2014 2,520.00 - - - -
December 1-31, 2014 7,650.00 12,870.96 - - -
January 1-31, 2015 1,650.00 45,855.21 - 15,000.00 -
February 1-28, 2015 5,280.00 - - - -
March 1-31, 2015 1,780.00 - - - -
April 1-30, 2015 21,115.00 - - 48,000.00 -
May 1-31, 2015 5,040.00 7,000.00 - -
June 1-30, 2015 3,650.00 - - - -
July 1-31, 2015 14,560.00 - - - -
August 1-31, 2015 10,300.00 - - - -
September 1-30, 2015 4,975.00 - - - -
October 1-31, 2015 3,105.00 - - 22,000.00 -
November 1-19, 2015 10,780.00 - - 6,000.00 -
TOTAL DEBITS TO ACCOUNTABILITY - 117,850.00 P 102,631.07 - P 146,000.00 -
Less: Credits to Accountability
Balance deposited - - -
July 1-31, 2014 - 4,455.00 - - - -
August 1-31, 2014 12,430.00 18,968.30 - 40,000.00 -
September 1-30, 2014 3,715.00 - - - -
October 1-31, 2014 - 4,845.00 17,936.60 - 15,000.00 -
November 1-30, 2014 2,520.00 - - - -
December 1-31, 2014 7,650.00 12,870.96 - - -
January 1-31, 2015 1,650.00 45,855.21 - - -
February 1-28, 2015 5,280.00 - 15,000.00
March 1-31, 2015 - 1,780.00 - -
April 1-30, 2015 21,115.00 - 48,000.00
May 1-31, 2015 - 5,040.00 7,000.00
June 1-30, 2015 - 3,650.00 - -
July 1-31, 2015 14,560.00 - -
August 1-31, 2015 10,300.00 - -
September 1-30, 2015 4,975.00 - -
October 1-31, 2015 - 3,105.00 - 22,000.00
November 1-19, 2015 10,550.00 6,000.00
TOTAL CREDITS TO ACCOUNTABILITY - 117,620.00 P 102,631.07 - P 146,000.00 -
BALANCE OF ACCOUNTABILITY
AS OF November 19, 2015 - 230.00 -
INVENTORY CASH AND/OR
ALLOWED CASH ITEMS 230.00 -
SHORTAGE/(OVERAGE) - - - - - -
I HEREBY CERTIFY that my accountability for the above funds of Department of Agrarian Reform, Provincial Office, South Cotabato

examination on November 19, 2015 is correctly stated totalling


[ ]
Accountable Officer's Signature Designation: Agency/Station Date:
EVELYN S. RAO Assistant Statistician/Collecting Officer Department of Agrarian Reform - Provincial Office, Sout November 19,
I HEREBY CERTIFY that the preceding is a true and correct report of the examination of the Cash and Accounts of:
Name of Accountable Officer: Designation: Agency/Station Date:
EVELYN S. RAO Assistant Statistician/Collecting Officer Department of Agrarian Reform - Provincial Office, Sout November 19,
REMARKS
Please see attached narrative report.
Signature of Auditor/Examiner Date:
DANILO C. CABIDOG/ABRAHAM U. MAGNO December 15, 2105
State Auditor IV/State Auditor I
1. This form will be used for the examination of all cash accountable officers in the corporate, national and local government offices.
2. Before proceeding to conduct an examination, the examiner should thoroughly familiarize himself with the revised manual on cash examination
3. The six(6) column on the face hereof are left blank to meet all fund requirements.
4. If the space provided for is not enough, use it as summary only and support it with schedules.
5. All reports of examination with their supporting papers and letters will be forwarded to their respective Regional Directors in duplicate. In the event
of shortage/irregularity, the procedures outlined under COA Memorandum 83-81B dated November 1983 should be strictly followed.
6. Checks, treasury warrants, money orders, and other cash items shall be listed on the space for inventory of Cash Items.
N T O F A C C O U N T A B I L I T Y

Total

4,455.00
71,398.30
4,715.00
36,781.60
2,520.00
20,520.96
62,505.21
5,280.00
1,780.00
69,115.00
12,040.00
3,650.00
14,560.00
10,300.00
4,975.00
25,105.00
16,780.00
366,481.07

-
4,455.00
71,398.30
3,715.00
37,781.60
2,520.00
20,520.96
47,505.21
20,280.00
1,780.00
69,115.00
12,040.00
3,650.00
14,560.00
10,300.00
4,975.00
25,105.00
16,550.00
366,251.07

230.00

230.00
-
at the time of
November 19, 2015

November 19, 2015

December 15, 2105


EVELYN S. RAO Annex G
Assistant Statistician/Collecting Officer
Department of Agrarian Reform - Provincial Office, South Cotabato
Koronadal City
AMOUNT OF BOND P 225,000.00
RISK NUMBER 68-15-0146R
EFFECTIVE DATE January 20, 2015

LIST OF COLLECTIONS AND REMITTANCES/DEPOSITS


LBP Account No. 2075-9000-95
Period Covered: July 1, 2014 to November 19, 2015

Date Qty. Inclusive Serial No. COLLECTIONS DEPOSITS


Beginning Balance - -
July 2-31, 2014 11 9011315 - 9011325 4,455.00 4,455.00
August 1-31, 2014 28 9011326 - 9011353 12,430.00 12,430.00
September 1-30, 2014 15 9011354 - 9011368 4,715.00 3,715.00
October 1-31, 2014 14 9011369 - 9011382 3,845.00 4,845.00
November 1-30, 2014 10 9011383 - 9011392 2,520.00 2,520.00
December 1-31, 2014 16 9011393 - 9011408 7,650.00 7,650.00
January 1-31, 2015 11 9011409 - 9011419 1,650.00 1,650.00
February 1-28, 2015 19 9011420 - 9011438 5,280.00 5,280.00
March 1-31, 2015 12 9011439 - 9011450 1,780.00 1,780.00
April 1-30, 2015 24 9011451 - 9011474 21,115.00 21,115.00
May 1-31, 2015 20 9011475 - 9011494 5,040.00 5,040.00
June 1-30, 2015 11 9011495 - 9011505 3,650.00 3,650.00
July 1-31, 2015 31 9011506 - 9011536 14,560.00 14,560.00
August 1-31, 2015 23 9011537 - 9011559 10,300.00 10,300.00
September 1-30, 2015 18 9011560 - 9011577 4,975.00 4,975.00
October 1-31, 2015 19 9011578 - 9011596 3,105.00 3,105.00
November 1-19, 2015 21 9011597 - 9011617 10,780.00 10,550.00
Grand Total 303 117,850.00 117,620.00

Prepared by:

ABRAHAM U. MAGNO
State Auditor I
Audit Team Member
Annex G

ANCES/DEPOSITS
0-95
mber 19, 2015

UNDEPOSITED
BALANCE
-
-
-
1,000.00

230.00

BRAHAM U. MAGNO
State Auditor I
Audit Team Member
EVELYN S. RAO Annex G
Assistant Statistician/Collecting Officer
Department of Agrarian Reform - Provincial Office, South Cotabato
Koronadal City
AMOUNT OF BOND P 225,000.00
RISK NUMBER 68-15-0146R
EFFECTIVE DATE January 20, 2015

LIST OF COLLECTIONS AND REMITTANCES/DEPOSITS


LBP Account No. 0752-0035-64
Period Covered: July 1, 2014 to November 19, 2015

Date Qty. Inclusive Serial No. COLLECTIONS DEPOSITS


Beginning Balance - -
July 2-31, 2014 - - -
August 1-31, 2014 2 5412417 - 5412418 18,968.30 18,968.30
September 1-30, 2014 -
October 1-31, 2014 2 5412419 - 5412420 17,936.60 17,936.60
November 1-30, 2014 -
December 1-31, 2014 2 5412421 - 5412422 12,870.96 12,870.96
January 1-31, 2015 2 5412423 - 5412424 45,855.21 45,855.21
February 1-28, 2015 -
March 1-31, 2015 -
April 1-30, 2015 -
May 1-31, 2015 2 5412425 - 5412426 7,000.00 7,000.00
June 1-30, 2015 -
July 1-31, 2015 -
August 1-31, 2015 -
September 1-30, 2015 -
October 1-31, 2015 -
November 1-30, 2015 -
Grand Total 10 102,631.07 102,631.07

Prepared by:

ABRAHAM U. MAGNO
State Auditor I
Audit Team Member
Annex G

ANCES/DEPOSITS
5-64
mber 19, 2015

UNDEPOSITED
BALANCE
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

BRAHAM U. MAGNO
State Auditor I
Audit Team Member
EVELYN S. RAO Annex G
Assistant Statistician/Collecting Officer
Department of Agrarian Reform - Provincial Office, South Cotabato
Koronadal City
AMOUNT OF BOND P 225,000.00
RISK NUMBER 68-15-0146R
EFFECTIVE DATE January 20, 2015

LIST OF COLLECTIONS AND REMITTANCES/DEPOSITS


LBP Account No. 2075-9001-09
Period Covered: July 1, 2014 to November 19, 2015

Date Qty. Inclusive Serial No. COLLECTIONS DEPOSITS


Beginning Balance - -
July 2-31, 2014 -
August 1-31, 2014 2 9011108 - 9011109 40,000.00 40,000.00
September 1-30, 2014 -
October 1-31, 2014 1 9011110 - 9011110 15,000.00 15,000.00
November 1-30, 2014 -
December 1-31, 2014 -
January 1-31, 2015 1 9011111 - 9011111 15,000.00 15,000.00
February 1-28, 2015 -
March 1-31, 2015 -
April 1-30, 2015 2 9011112 - 9011113 48,000.00 48,000.00
May 1-31, 2015 -
June 1-30, 2015 -
July 1-31, 2015 -
August 1-31, 2015 -
September 1-30, 2015 -
October 1-31, 2015 2 9011114 - 9011115 22,000.00 22,000.00
November 1-30, 2015 2 9011116 - 9011117 6,000.00 6,000.00
Grand Total 10 146,000.00 146,000.00

Prepared by:

ABRAHAM U. MAGNO
State Auditor I
Audit Team Member
Annex G

ANCES/DEPOSITS
1-09
mber 19, 2015

UNDEPOSITED
BALANCE
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

BRAHAM U. MAGNO
State Auditor I
Audit Team Member
4,455.00 45,855.21
1,650.00
12,430.00 15,000.00
18,968.30 5,280.00
40,000.00 1,715.00
4,715.00 48,000.00
3,845.00 21,115.00
15,000.00 9,115.00
17,936.60 7,000.00
2,520.00 5,040.00
7,650.00 4,780.00
12,870.96 3,650.00
14,560.00
4,040.00
10,300.00
9,910.00
4,975.00
22,000.00
3,105.00
1,910.00
140,390.86 239,000.21