Republic of the Philippines

Department of Education
Region V
SCHOOLS DIVISION OFFICE OF ALBAY
Ligñon Hill, Bogtong, Legazpi City
Telefax : (052) 481-5939. Website:www.depedalbay.com.ph

Serial No. : 2016-01-0002

Date : January 13, 2016

OBLIGATION REQUEST AND STATUS Fund Cluster :

101101
101407
104102
Others : ___________
Payee BICOL ASSOCIATION OF SCHOOLS SUPERINTENDENTS (BASS) -LBP Legazpi , SA # 0131-2815-95
Office

Address Legazpi City

Responsibility
Particulars MFO/PAP UACS Object Code Amount
Center

103001000100000
To payment for registration fees in attendance 269002000800000 5020201000 81,000.00
to the Fourth Deped-Bicol Regional Research 270003020100000
Conference on January 21-23 at Villa Caceres Ho 261003020500001
Naga City per attached SDO Memorandum. 261003020500002 5020201000 62,100.00
SDO (Inset) 30 262003020500003 5020201000 13,500.00
Elem. 23
Sec. 5
Total 58

Total 156,600.00
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: ANTERO S. BUIZA Printed Name: ALBERT B. BONAGUA

Position Administrative Officer V Position : Administrative Officer V (Budget)
:
Budget Officer III
Date : Date :

C. STATUS OF OBLIGATION
Reference Amount
Balance
ORS/JEV/Check/ Obligation Payable Payment Due and
Date Particulars Not Yet Due
ADA/TRA No. Demandable
(a) (b) (c) (a-b) (b-c)

42
 Proposed
REPORT OF CHECKS ISSUED
Period Covered: ________________
01/28
2014-01-028
Agency : JDG Department Report No.: ___________
Fund : 01 1234
Bank Name/Account No. _________________ 1
Sheet No.: _______________
Check DV No. / ORS/BUR Responsibility UACS Code/
Payee MFO/PAP/KRA Amount
Date No. Payroll No. Center Code Expenditure
1/28 023 2014-02-010 010 26-036-00-00000 ABC Corporation 3 01 01 0000 50604050 03 44,000 00
123

44,000 00

CERTIFICATION
I hereby certify that this Report of Checks Issued (RCI) in _________ sheet(s) is a full,
true and correct statement of all checks issued by me in payment for obligations for the period stated and
shown in the attached disbursement vouchers.
AO 6/15/02

Juan dela Cruz 01/29/14

Disbursing Date
Officer
 Republic of the Philippines
Department of Education
Region V
SCHOOLS DIVISION OFFICE OF ALBAY
Ligñon Hill, Bogtong, Legazpi City
Telefax : (052) 481-5939. Website:www.depedalbay.com.ph

Serial No. :

Date :

OBLIGATION REQUEST AND STATUS Fund Cluster :

101101
101407
104102
Others : ___________
Payee ROMEL B. BAYABAN,THE PRINCIPAL, LBP ACCOUNT NO. 000132-0280-87
Office BATAN HIGH SCHOOL
Address BATAN, RAPU-RAPU, ALBAY
Responsibility
Particulars MFO/PAP UACS Object Code Amount
Center

100000100001002 5020101000 6,000.00

TO CASH ADVANCE THE JUNIOR HS 310500100001000 5020201000 6,000.00
MOOE FOR OCTOBER, 2019… 200000100006000 5021202000 6,000.00
310100100002000 5021203000 6,000.00
310100100004000 5020402000 8,000.00
310400100002000 5020399000 8,000.00
310400100003000
310400100004000

Total 40,000.00
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)
:
Budget Officer III
Date : Date :

C. STATUS OF OBLIGATION
Reference Amount
Balance
ORS/JEV/Check/ Obligation Payable Payment Due and
Date Particulars Not Yet Due
ADA/TRA No. Demandable
(a) (b) (c) (a-b) (b-c)