BUDGET UTILIZATION REQUEST AND STATUS Serial No.

:
NATIONAL FOOD AUTHORITY REGIONAL OFFICE IV Date:
Entity Name Fund Cluster:

Payee PIO A. VILLACES

Office NFA REGIONAL OFFICE IV

Address BATANGAS CITY

UACS Object
Responsibility
Particulars MFO/PAP Code/
Center
Expenditures

REIMBURSEMENT OF TRAVELLING
EXPENSES INCURRED WHILE ON
OFFICIAL TRAVEL ON JULY 29-30, 2019
AT NFA PALAWAN.

Total

A. B.
Certified: Charges to appropriation/budget necessary, Certified: Budget available and utilized for
lawful and under my direct supervision; and supporting the purpose/adjustment necessary as
documents valid, proper and legal indicated above

Signature: Signature:
Printed Name: MIGUEL S. TECSON Printed Name: LOLITA M. DEL MUNDO
Position: Asst. Regional Director Position: Budget Officer III
Head, Requesting Office/Authorized Representative Head, Budget Division/Unit/Authorized Represent

Date: Date:
C. STATUS OF UTILIZATION
Reference Amount

BURS/JEV/RCI/ Utilization Payable Payment

Date Particulars
RADAI/RTRAI No.
(a) (b) (c)
 Appendix 14

d Cluster:

Amount

Php 2,466.01

Php 2,466.01

Budget available and utilized for

/adjustment necessary as

LOLITA M. DEL MUNDO

Budget Officer III
Head, Budget Division/Unit/Authorized Representative
mount
Balance
Not Yet Due Due and
Demandable
(a-b) (b-c)
 Appendix 32
Fund Cluster:
NATIONAL FOOD AUTHORITY REGIONAL OFFICE IV
Entity Name
Date:

DISBURSEMENT VOUCHER DV No.:

Mode of
Payment MDS Check Commercial Check ADA Others (Please specify)
_________________
Payee TIN/Employee No.: ORS/BURS No.:
PIO A. VILLACES
118802
Address BATANGAS CITY

Responsibility
Particulars MFO/PAP Amount
Center

REIMBURSEMENT OF TRAVELLING EXPENSES Php 5,331.59

INCURRED WHILE ON OFFICIAL TRAVEL ON
JULY 29-30, 2019 AT NFA PALAWAN.

Php 5,331.59

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

MIGUEL S. TECSON
ASST. REGIONAL DIRECTOR

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment

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

Signature Signature
Printed Name REBECCA H. ANDAL Printed Name MIGUEL S. TECSON
Accountant IV Asst. Regional Director
Position Head, Accounting Unit/Authorized Representative Position Agency Head/Authorized Representative

Date Date
E. Receipt of Payment
JEV No.
Check/ADA Date: Bank Name & Account Number:
No.:
Signature: Date: Printed Name: Date

Official Receipt No. & Date/Other Documenjts

 Appendix 32
Fund Cluster:

Date:

DV No.:

_______________
ORS/BURS No.:

Amount

Php 5,331.59

Php 5,331.59
pervision.

Credit
EL S. TECSON
egional Director
uthorized Representative