Appendix 44
LIQUIDATION REPORT Register No.
Period Covered: _____________ FOR THE MONTH OF ________________ Date:
Entity Name: ___________________________________________ Responsibility Center Code:
Fund Cluster : _____________________________________________ __________________________
PARTICULARS AMOUNT
To liquidate CA for SBFP for the Month of ___________________ under Register No.
__________________________________ Php ________________
ACCOUNTING ENTRY
Account Description UACS Object Code Debit Credit
Due to BIR 2020101000
Advances for Special
1990103000
Disbursing Officer
TOTAL AMOUNT SPENT -
AMOUNT OF CASH ADVANCE PER Check No. __________DTD
-
__________________
PREVIOUS BALANCE -
TOTAL UNLIQUIDATED BALANCE -
A Certified: Correctness of the B Certified: Purpose of travel / Certified: Supporting documents
above data cash advance duly accomplished complete and proper
NORMA B. SAMANTELA, CESO IV HONEY CHASE L. MESA
Principal SDS Senior Bookkeeper
JEV No.: ___________________
Date: ______________________ Date: _____________________ Date: _____________________
Appendix 32
SCHOOLS DIVISION OFFICE OF ALBAY Fund Cluster :
(Name of School)
Jovellar, Albay Date :
DV No. :
DISBURSEMENT VOUCHER
Mode of MDS Check ✓ Commercial Check ADA Others (Please specify)
Payment
_________________
Payee TIN/Employee No.: ORS/BURS No.:
Address
Responsibility
Particulars MFO/PAP Amount
Center
To Payment for :
Gross
Less: Tax ___%
___%
Amount Due Php -
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
____________________________________
School Head
B. Accounting Entry:
Account Title UACS Code Debit Credit
C. Certified: D. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
Supp
proper
Signature Signature
Printed
Printed Name
Name HONEY CHASE L. MESA
Administrative Assistant III
Position Position
School Bookkeeper School Head
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Signature : Date : Printed Name: Date
Official Receipt No. & Date/Other Documents
Appendix 43
CDReg01
CASH DISBURSEMENTS REGISTER
Entity Name: _______________________________________ Name of Accountable Officer: Marko Mupit
Sub-Office/District/Division: Jovellar District Official Designation: School Principal
Municipality/City/Province: Albay Station: Cabraran Pequeno ES
Fund Cluster : ______________________________________ Register No. : MOOE-111629-2021-01-001
Sheet No. : 1 of 1
Advances for
Operating Expenses BREAKDOWN OF PAYMENTS
(19901010)
Repairs and
Check Maintenance -
Amount Transportation Other Supplies Telephone Printing and Fidelity
Date No./LDDAP- DV Number Payee Particulars Office Supplies Electricity Janitorial Other General Building and
ADA and Delivery and Materials Expenses - Publication Bond
Expense Expenses Services Services Other Structures
Expense Expenses Mobile Expenses Premiums
Cash (School
Payments Due to BIR Balance Buildings)
Advance
(5020301000) (5029904000) (5020399000) (5020402000) (5020502001) (5021202000) (5021299000) (5021305002) (5029902000) (50215020)
Balance Carried Forward -
CA ________ for the month of -
___________ net of tax withheld
previous on previous liquidation
-
117
Totals - - - - - - - - - - - - -
Recapitulation:
UACS Object
Account Description Amount
Code
The total of the ‘Advances for Operating Expenses – Payments’ column must always be equal to the sum of the totals of the ‘Breakdown of Payments’ columns.
CERTIFIED CORRECT: CERTIFIED: SUPPORTING DOCUMENTS COMPLETE
HONEY CHASE L. MESA
School Principal Administrative Assistant III / Senior Bookkeeper
Date: ____________________ Date: ______________________
Department of Education
Division of Albay
_________________________________________________
(Name of School)
PURCHASE ORDER
Supplier:_____________________________ P.O No. : ________________________________
Address: _____________________________ Date : ________________________________
TIN: _____________________________ Mode of Procurement : ____________________
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:
Place of Delivery : ______________________________ Delivery Term: ________________
Date of Delivery : ______________________________ Payment Term: ________________
Stock No. Unit Description Quantity Unit Cost Amount
(Amount in Words) Php
In case of failure to make the full delivery within the time
specified above, a penalty of one-tenth (1/10) of one percent
for every day of delay shall be imposed.
Very truly yours,
Principal
Conforme:
______________________________________
Signature over Printed Name of Supplier
_____________________
(Date)
FUNDS AVAILABLE:
ORS NO.
HONEY CHASE L. MESA
DATE:
AMOUNT: School Bookkeeper
