Fund Cluster :

Date : Dec. 3, 2018

DISBURSEMENT VOUCHER DV No. : 2018-12-

Mode of MDS Check Commercial Check ADA Others (Please specify)

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee C.B. CAPATANG STORE

Address Sto. Niño, Sto. Domingo, Albay

Responsibility
Particulars MFO/PAP Amount
Center

TO PAYMENT FOR THE PROCUREMENT OF LPG-REFILL USED

IN THE SBFP 2018-2019 PER SUPPORTING DOCUMENTS 700.00
HERETO ATTACHED IN THE AMOUNT OF…….

Amount Due 700.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

EVA V. BESMONTE
School Head

B. Accounting Entry:
Account Title UACS Code Debit Credit
700.00
700.00

C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable)
Sup
proper

Signature Signature

Printed
Printed Name
Name SHEILA Z. SERILLA EVA V. BESMONTE
SCHOOL BOOKKEEPER
Position Position SCHOOL HEAD

Date December 3, 2018 Date December 3, 2018

E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : December 3, 2018 Printed Name: Corazon B. Balaoro Date
Signature :
Official Receipt No. & Date/Other Documents
 Republic of the Philippines
Department of Education
Region V
SCHOOLS DIVISION OF ALBAY
Ligñon Hill, Bogtong, Legazpi City
Telefax: (052) 481-5939. Website: www.depedalbay.com.ph

Serial No.:
Date:
Fund Cluster :
OBLIGATION REQUEST AND STATUS 101101
101407
104102
Others

Payee

Office STA. MISERICORDIA ES

Address STO. DOMINGO DISTRICT

Responsibility Center Particulars MFO/PAP UACS Object Code Amount

100000100001002
310500100001000
200000100006000
310100100002000
310100100004000
310400100002000
310400100003000
310400100004000

Total -
A. Certified: Charges to appropriation/alloment are B. Certified: Allotment available and obligated
necessary, lawful and under my direct supervision;and for the purpose/adjustment necessary as
supporting documents valid, proper and legal indicated above

Signature : ___________________________________ Signature : ______________________________

Printed Name: ____________________________ Printed Name: ALBERT B. BONAGUA

Position : ____________________________ Position : Administrative Officer V (Budget)

Head, Requesting Office/Authorized
Budget Officer III
Representative
Date : ___________________________________ Date : ____________________________

D
C. STATUS OF OBLIGATION ue
Reference Amount an
Balance d
ORS/JEV/Check/ Obligation Payable Payment D
Date Particulars Not Yet Due (b
e
ADA/TRA No. -
m
(a) (b) (c) (a-b) c)
an
da
bl
e
 Republic of the Philippines Fund Cluster :
Department of Education
Region V 101101
SCHOOLS DIVISION OF ALBAY 101407
Ligñon Hill, Bogtong, Legazpi City 104102
Telefax : (052) 481-5939. Website: www.depedalbay.com.ph Others
Date : December 5,
2018
DV No. :
DISBURSEMENT VOUCHER

Mode of MDS Check Commercial Check ADA Others (Please specify)

Payment

TIN/Employee No.: ORS/BURS No.:

Payee EVA V. BESMONTE

Address BUHATAN ELEMENTARY SCHOOL/ STO. DOMINGO DISTRICT/ STO. DOMINGO, ALBAY

Responsibility
Particulars MFO/PAP Amount
Center

TO CASH ADVANCE SBFP/PPAN BUDGET FOR THE

MONTH OF DECEMBER 2018 IN THE AMOUNT OF Php. 22,512.00
……………………………………
PPAN 3,684.00
SBFP 18,828.00

Amount Due P 22,512.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

EDGAR O. ORELLANA

B. Accounting Entry:
Account Title UACS Code Debit Credit
ADVANCES TO SPECIAL DISBURSING OFFICER 1990103000 22,512.00
CASH, MDS - REGULAR 1010404000 22,512.00
-
C. Certified: D. Approved for Payment
Cash available P
Subject to Authority to Debit Account (when applicable)
Sup
proper

Signature Signature

Printed Printed
Name RAFAEL B. TRAJANO Name JOSE L. DONCILLO
Division Accountant
Position Position Schools Division Superintendent

Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account
ADA No. : Number:
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents
 Republic of the Philippines
Department of Education
Region V
SCHOOLS DIVISION OF ALBAY
Ligñon Hill, Bogtong, Legazpi City
Telefax: (052) 481-5939. Website: www.depedalbay.com.ph

Serial No.:
Date: MAY 24, 2019
Fund Cluster :
OBLIGATION REQUEST AND STATUS 101101
101407
104102
Others

Payee EVA V. BESMONTE

Office BUHATAN ELEMENTARY SCHOOL

Address STO. DOMINGO DISTRICT/ STO. DOMINGO, ALBAY

Responsibility Center Particulars MFO/PAP UACS Object Code Amount

100000100001002
TO CASH ADVANCE HARDSHIP 310500100001000 Php. 185, 650.67
ALLOWANCE BUDGET FOR THE 200000100006000
MONTHS OF JANUARY TO APRIL 2019 310100100002000
IN THE AMOUNT OF
310100100004000
310400100002000
310400100003000
JANUARY Php 51, 602.37 310400100004000
FEBRUARY 56, 765.93
MARCH 60, 016.45
APRIL 17, 265.92

TOTAL Php. 185, 650.67

Total Php 185, 650.67
A. Certified: Charges to appropriation/alloment are B. Certified: Allotment available and obligated
necessary, lawful and under my direct supervision;and for the purpose/adjustment necessary as
supporting documents valid, proper and legal indicated above

Signature : _________________________ Signature : ______________________________

Printed Name: FATIMA D. BUEN Printed Name: ALBERT B. BONAGUA

Position : Asst. Schools Division Superintendent Administrative Officer V (Budget)

Head, Requesting Office/Authorized
Budget Officer III
Representative
Date : May 24, 2019 Date : ____________________________

D
C. STATUS OF OBLIGATION ue
Reference Amount an
Balance d
ORS/JEV/Check/ Obligation Payable Payment D
Date Particulars Not Yet Due (b
e
ADA/TRA No. -
m
(a) (b) (c) (a-b) c)
an
da
bl
e