Barangay Sambag, Jaro Iloilo City TRANSMITTAL LETTER DATE: January 14, 2012

TO : Ms. Michelle O. Lopez City Accountant Iloilo City Dear Madam: Pursuant to the COA Accounting Circular No. 2006-002 dated December 19, 2006, I hereby transmit the following reports and supporting schedules for the period indicated therein: ( / ) Monthly Report ( ) Year-end Report ( ) Others Submitted by:

LUVISMINDA C. MIRASOL Brgy. Record Keeper

Name of Report/Register/Summary A. Monthly Reports (Check applicable Form) Name of Report/Register/Summary Month/Period Covered Remarks (by the Accountant)

A. Monthly Reports (Check applicable Form) (/) CASH RECEIPT & DEPOSIT REGISTER (/) CASH ON HAND & IN BANK REGISTER (/) CASH DISBURSEMENT REGISTER (/) CHECK DISBURSEMENT REGISTER (/) SUMMARY OF COLLECTIONS & DEPOSITS (/) SUMMARY OF CHECKS ISSUED (/) SUMMARY OF CASH PAYMENTS (/) BARANGAY PAYROLL B. Others (/) INSPECTION & ACCEPTANCE

December, 2012 December, 2012 December, 2012 December, 2012 December, 2012 December, 2012 December, 2012 December, 2012 December, 2012

ACKNOWLEDGEMENT: ( ) I hereby acknowledge receipt of the above documents complete with supporting schedules. ( ) I noted the following deficiencies in the reports as shown on the remarks above. Please submit on or before _______________________.

MICHELLE O. LOPEZ City Accountant

CASH RECEIPTS AND DEPOSITS REGISTER For the Month of December, 2012 Barangay : Sambag, Jaro Barangay Treasurer : MERLY R. DEFENSOR DATE 2012 PARTICULARS REF DEPOSITS REMITTANCE City City/Municipality : ILOILO CITY Province : ILOILO UNDEPOSITED UNREMITTED COLLECTIONS Distribution of Receipts IRA RPT Clearance & Cert. Fees Misc. Income Others Account Amount Classification CRD Reg. No. 12-12-001

Total Certification: I hereby certify to the correctness of the above data. Recordings are based on the certified SCDs supported with duplicate copies of ORs and VDs submitted by the BT., CMs and bank statements which are all in my life.

LUVISMINDA C. MIRASOL
Signature Over Printed Name

Date

Barangay Record Keeper

CASH ON HAND & IN BANK REGISTER For the Month of December, 2012 Barangay : Sambag, Jaro Barangay Treasurer : MERLY R. DEFENSOR DATE 2012 PARTICULARS Ref. Receipt (In) City/Municipality : ILOILO CITY Province : ILOILO Cash on Hand Deposit Balance (Out) CRD Reg. No. Cash in Bank Checks/CM/Bnks (Out)

Deposits/CM/Bnks (In)

Balance

Certification: I hereby certify to the correctness of the above data. Recordings are based on the SCDs, SCkls, Debit/Credit Memos and Bank Statement received which are all submitted to the BRK.

Acknowledgement: This is to acknowledge that I have received from Brgy. Treasurer the CHBReg. supported w/ SCDs, Chkls, Debit/Credit Memos and Bank Statements together w/ all the supporting documents.

MERLY R. DEFENSOR
Signature Over Printed Name

LUVISMINDA C. MIRASOL Date

Signature Over Printed Name

Date

Barangay TREASURER

Barangay Record Keeper

CASH DISBURSEMENT REGISTER For the Month of December, 2012 Barangay : Sambag, Jaro Barangay Treasurer : MERLY R. DEFENSOR Payroll Fund DATE 2012 PARTICULARS Ref. Cash Advance Disbursement Balance Honoraria City/Municipality : ILOILO CITY Province : ILOILO CRD Reg. No. 12-12-001 Breakdown of Expenditures BHW, Clerk & Tanod Janitor Allowances Allowance Deduction Due from Officers & Employees

Other Personnel Benefits

Total Certification: I hereby certify to the correctness of the above data. Records are based on the SCP submitted by the AO and that all the original paid DVs/Payrolls are in my file.

LUVISMINDA C. MIRASOL
Signature Over Printed Name

Date

Barangay Record Keeper