Download - Disbursement Voucher form.xls
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