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Appendix 32

SOCORRO NATIONAL HIGH SCHOOL Fund Cluster :


Entity Name 101
Date :
DISBURSEMENT VOUCHER DV No. :

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


Payment
_________________

Payee LILETH Q. JUANITE TIN/Employee No.: ORS/BURS No.:

Address
SOCORRO, SURIGAO DEL NORTE
Responsibility
Particulars MFO/PAP Amount
Center
To payment of travelling expenses per supporting 70010916177 262003020500003 2,380.00
papers hereto attached..

Amount Due 2,380.00


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

DANTE S. DACERA
Principal I
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit
Travelling Expenses 5020101000
Cash-Modified Disbursement System, Regular 1010404000

C. Certified: D. Approved for Payment


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

Signature Signature

Printed
Printed Name
Name GLORINA C. ERONG DANTE S. DACERA
Senior Bookkeeper Principal I
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.


Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: DBP Date
Signature :
Official Receipt No. & Date/Other Documents

92
Appendix 32

Fund Cluster :
Entity Name 101
Date :
DISBURSEMENT VOUCHER DV No. :

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


Payment
_________________

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

Address

Responsibility
Particulars MFO/PAP Amount
Center
70010916177 262003020500003

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

DANTE S. DACERA
Principal I
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit
Office Supplies Expenses 5020301000
Cash-Modified Disbursement System, Regular 1010404000

C. Certified: D. Approved for Payment


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

Signature Signature

Printed
Printed Name
Name GLORINA C. ERONG DANTE S. DACERA
Senior Bookkeeper Principal I
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.


Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: DBP Date
Signature :
Official Receipt No. & Date/Other Documents

92
Appendix 32

Fund Cluster :
Entity Name 101
Date :
DISBURSEMENT VOUCHER DV No. :

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


Payment
_________________

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

Address

Responsibility
Particulars MFO/PAP Amount
Center
70010916177 262003020500003

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

DANTE S. DACERA
Principal I
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit
Tellephone Expenses 5020502000
Cash-Modified Disbursement System, Regular 1010404000

C. Certified: D. Approved for Payment


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

Signature Signature

Printed
Printed Name
Name GLORINA C. ERONG DANTE S. DACERA
Senior Bookkeeper Principal I
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.


Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: DBP Date
Signature :
Official Receipt No. & Date/Other Documents

92
Appendix 32

Fund Cluster :
Entity Name 101
Date :
DISBURSEMENT VOUCHER DV No. :

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


Payment
_________________

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

Address

Responsibility
Particulars MFO/PAP Amount
Center
70010916177 262003020500003

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

DANTE S. DACERA
Principal I
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit
Internet Subscription Expenses 5020503000
Cash-Modified Disbursement System, Regular 1010404000

C. Certified: D. Approved for Payment


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

Signature Signature

Printed
Printed Name
Name GLORINA C. ERONG DANTE S. DACERA
Senior Bookkeeper Principal I
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.


Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: DBP Date
Signature :
Official Receipt No. & Date/Other Documents

92
Appendix 32

Fund Cluster :
Entity Name 101
Date :
DISBURSEMENT VOUCHER DV No. :

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


Payment
_________________

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

Address

Responsibility
Particulars MFO/PAP Amount
Center
70010916177 262003020500003

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

DANTE S. DACERA
Principal I
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit
Electricity Expenses 5020402000
Cash-Modified Disbursement System, Regular 1010404000

C. Certified: D. Approved for Payment


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

Signature Signature

Printed
Printed Name
Name GLORINA C. ERONG DANTE S. DACERA
Senior Bookkeeper Principal I
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.


Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: DBP Date
Signature :
Official Receipt No. & Date/Other Documents

92

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