Sheet1General Form No. 7(A)TIME BOOK AND PAYROLLRevised August, 1948For payment of prizes during the Barangay 11 Nutrition Month Celebration at Barangay 11, Malaybalay City, Bukidnon, Philippines, for the period of July to August 2015.(State job or project on which labor was performed)OccupationTIME ROLLWAGESDEDUCTIONSRESIDENCE CERTIFICATE(Market time each day under proper date usingSIGNATURE ORNO.NAMEfraction when necessary)NO. OF DAYS WORKEDRATE PER DAYTOTAL AMOUNTTerm InsuranceMedicareTotal DeductionsNet AmountTHUMB MARKPlace of123456789101112131415NUMBERDATEIssue16171819202122232425262728293031TALIPAPA11st Prize1,000.001,000.0022nd Prize750.00750.0033rd Prize500.00500.004Consol200.00200.005Consol200.00200.006Consol200.00200.007Consol200.00200.00POSTER MAKING81st Prize500.00500.0092nd Prize300.00300.00103rd Prize200.00200.0011Consol100.00100.0012Consol100.00100.0013Consol100.00100.0014Consol100.00100.00HEALTHY BABY151st Prize500.00500.00162nd Prize300.00300.00173rd Prize200.00200.0018Stiphend875.00875.0018Stiphend875.00875.00TOTAL7,200.000.07,200.001. I HEREBY CERTIFY that each person whose name appears on2. I CERTIFY that this roll is correct, every person whose name3. I CERTIFY on ,my official oath that I have this_________daythis roll rendered service as indicated and for the time stated.appears hereon rendered service for the time and at the rates stated,of __________, ____paid in cash to each man whose name appearunder my general supervision, and I approve payments of this roll.on the bove roll, the amount set opposite his name, he havingpresented himself, established his identify, and fixed his signature\or thumb mark on the space provided therefore. Unpaid servicesare indicated by red ink through the column "Amount Paid"KAG. RAFFY J. RONCALESHON. EMILIO R.CIDJULIE P. MAGSACAYChairman, Finance and AppropriationSuperinted or Foreman In-ChargeSpecial Disbursing Officer, PaymasterPrincipalBarangay ChairmanNOTE: - Where thumb mark is to be used in place of signature and the space available is not sufficient the thumb mark may be impressed on the back hereof withproper indication of the corresponding laborer's number and on the corresponding line on the payroll a remark "see thumb mark on the back" should be written.

Sheet2uses of12

Sheet3ALT+TABSwitch to the next program.ALT+SHIFT+TABSwitch to the previous program