Annex A
REPUBLIC OF THE PHILIPPINES
PROVINCE OF PANGASINAN
MUNICIPALITY OF SAN FABIAN
OBLIGATION REQUEST NO.
Payee
Office
Address
Responsibility Account
Center F.F.P. Code Amount
Total
Certified Certified
Charges to appropriation/allotment necessary, Existence of available appropriation
lawful and under my direct supervision
Supporting documents valid, proper and legal
Signature Signature
Printed Printed
Name MELECIA B. SAGUN Name ZENAIDA F. TAMONDONG
Position SWO IV Position Municipal Budget Officer
Date Date