ANNEX B

Republic of the Philippines

PROVINCIAL GOVERNMENT OF KALAYAAN, LAGUNA

Kalayaan, LagunaNo. 100 - -2006-07-

DISBURSEMENT VOUCHERMode of

Check Cash OtherPayment

Payee Bureau of TreasuryTIN/Employee No. Obligation Request No.

AddressSan Pablo City Responsibility Center

Office/Unit/Project Code

EXPLANATION AMOUNT

To: Payment of Fire Code Fee of this Municipality for the

month of April to June 2006. As per supporting papers hereto attached in the

amount of… Php 186.41

Php 186.41 A. Certified: B. Certified: Allotment obligated for the purpose as indicate above

Supporting documents complete

Signature Signature Printed

MERLE R. BADELDate: Printed

ARSENIA R. PONCEDate:

Name Name

PositionMunicipal Accountant

PositionMunicipal Treasurer

Head, Accounting Unit/ Authorized Representative Treasurer/ Authorized Representative

C. Approved for Payment D. Received Payment

SignatureCheck No. Bank Name: Date:

Printed

EMMANUEL C. MAGANADate: Signature

Name Printed

Bureau of Treasury Date:

Name

PositionMunicipal Mayor OR/Other Documents JEV No. Date:

Agency Head/ Authorized Representative

Fund Available

ANNEX B

Republic of the Philippines

PROVINCE OF LAGUNA

KALAYAANNo.

DISBURSEMENT VOUCHER 100-2010-10-

Mode of Check Cash Other

Payment

ARSENIA R. PONCEObligation Request No.

100-2010-10-

AddressKalayaan, Laguna

Office/Unit/Project Code

EXPLANATION AMOUNT

To: Cas advance payment for the expenses to be incurred in LAKBAY ARAL Php 10,400.00 to be held on July 27 to 29, 2012 in Ilocos Region as per suppoting papershereto attached in the amount of . . . . . . . . . . . . . . . . . .

Php 10,400.00 A. Certified: B. Certified: Allotment obligated for the purpose as indicate above Fund Available

Supporting documents complete

Signature Signature Printed

MERLE R. BADELDate: Printed

ARSENIA R. PONCEDate:

Name Name

PositionMun. Accountant

PositionMunicipal Treasurer

Head, Accounting Unit/ Authorized Representative Treasurer/ Authorized Representative

C. Approved for Payment D. Received Payment

SignatureCheck No. Bank Name: Date:

LAND BANK Printed

TEODORO A. ADAO JR.Date: Signature

Name Printed

ARSENIA R. PONCEDate:

Name

PositionMunicipal Mayor OR/Other Documents JEV No. Date:

Agency Head/ Authorized Representative

X

JOURNAL ENTRY VOUCHERMunicipality of KALAYAAN

LGU

Collection Check Disbursement

ACCOUNTING ENTRIES

Account P AMOUNTResponsibility Accounts & Explanation Code R Debit

Center

Due to other NGA's 416 186.41 Due to LGU's 418 336.00

17,352.25 30,040.57 26,967.02 14,763.30

Cash in bank LCCA 111

TOTAL 89,645.55

Prepared by: Approved by:

ANGEL RUTH A. FERRER MERLE R. BADEL

Municipal Accountant

ANNEX G-3

1000607

April 17, 2023

Cash Disbursement

AMOUNTCredit

89,645.55

89,645.55

MERLE R. BADELMunicipal Accountant

DISBURSEMENT VOUCHER (DV)

Instructions

of Accounting Unit or his authorized

in three copies to be distributed as follows: representative as to obligation of allotment

for the purpose as indicated and

completeness of supporting documents.

The certifying officer shall affix his

signature, print his name, indicate his

B. The Accounting Unit shall stamp the date of position, and the date of his signing on the

receipt on the face of this form. spaces provided.

C. This form shall be accomplished in the

following manner: Treasurer of his Authorized Representative

on the availability of fund.

Accounting Unit. It shall be nembered as

follows:

by the Agency Head of his Authorized

Representative on the payment covered

Serial number by the DV.

(one series for each year)

Month

Year by the claimant or his duly authorized

representative for the receipt of the

the appropriate box opposite the mode of check/cash and the date of receipt. The

payment. claimant/payee shall affix his signature on

the spaces provided and shall indicate the

number and the date of the check, bank name

Number (TIN) of the claimant/Identification and number and date of OR/ other relevant

Number assigned by the agency to the documents issued to acknowledge the receipt

officer/employee. of payment.

obligation request supporting the DV

Journal Entry Voucher.

and Code) - the office/unit/project and code

assigned to the cost center where the

disbursement shall be charged.

disbursement.

A. The DV shall be printed in one whole sheet of 10. Certified (Box A) - certification of the Head

8 1/2 x 11 size bond paper. This shall be prepared

Original - Accounting Unit

Duplicate - Cash UnitTriplicate - Payee

11. Certified (Box B) - certification by the

1. DV No. - number assigned to the DV by the

12. Approved for Payment (Boxed C) - approval

0000 00 0000

13. Received Payment (Box D) - Acknowledgment

2. Mode of Payment - put a check " " mark in

3. Payee - name of the payee of creditor.

4. TIN/Employee No. - Tax Identification

5. Obligation Request No. - Number of the

14. JEV No. and Date - Number and date of the 6. Address - address of the claimant

7. Responsibility Center (Office/Unit/Project

8. Explanation - brief description of the

9. Amount - amount of claim.

DISBURSEMENT VOUCHER (DV)

Instructions

representative as to obligation of allotment

completeness of supporting documents.

signature, print his name, indicate his

position, and the date of his signing on the

Treasurer of his Authorized Representative

by the Agency Head of his Authorized

Representative on the payment covered

by the claimant or his duly authorized

check/cash and the date of receipt. The

claimant/payee shall affix his signature on

the spaces provided and shall indicate the

number and the date of the check, bank name

and number and date of OR/ other relevant

documents issued to acknowledge the receipt

- certification of the Head

- certification by the

Approved for Payment (Boxed C) - approval

Acknowledgment

Number and date of the