Cagayan Valley Medical Center: Certification of Expenses Not Requiring Receipts
Cagayan Valley Medical Center: Certification of Expenses Not Requiring Receipts
Cagayan Valley Medical Center: Certification of Expenses Not Requiring Receipts
TOTAL 400.00
Purpose
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and
services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is
punsihable by law.
Certified correct: Noted by:
Signature
Printed Name REIA DOREEN M. RUECO DAISY A. ANDAL, MPA
Employee Immediate Supervisor
Date Date
TOTAL 400.00
Purpose
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and
services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is
punsihable by law.
Certified correct: Noted by:
Signature
Printed Name REIA DOREEN M. RUECO DAISY A. ANDAL, MPA
Employee Immediate Supervisor
Date Date
CAGAYAN VALLEY MEDICAL CENTER
TOTAL 400.00
Purpose
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and
services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is
punsihable by law.
Certified correct: Noted by:
Signature
Printed Name MICHELLE C. SORIANO EDWIN C. BALISI
Employee Immediate Supervisor
Date Date
TOTAL 400.00
Purpose
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and
services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is
punsihable by law.
Certified correct: Noted by:
Signature
Printed Name MICHELLE C. SORIANO EDWIN C. BALISI
Employee Immediate Supervisor
Date Date
CAGAYAN VALLEY MEDICAL CENTER
TOTAL
Purpose
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goo
services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statemen
punsihable by law.
Certified correct: Noted by:
Signature
Printed Name RINA JOY T. ANTONIO JASSEL S. TAMAYAO, CPA
Employee Immediate Supervisor
Date Date
TOTAL
Purpose
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goo
services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statemen
punsihable by law.
Certified correct: Noted by:
Signature
Printed Name RINA JOY T. ANTONIO JASSEL S. TAMAYAO, CPA
Employee Immediate Supervisor
Date Date
NTER
NG RECEIPTS
ne 19, 2017
AMOUNT (Php)
50.00
150.00
150.00
50.00
400.00
Noted by:
NTER
NG RECEIPTS
ne 19, 2017
AMOUNT (Php)
50.00
150.00
150.00
50.00
400.00
Noted by:
TOTAL
Purpose
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goo
services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statemen
punsihable by law.
Certified correct: Noted by:
Signature
Printed Name ALYSSA D. TULIAO JASSEL S. TAMAYAO, CPA
Employee Immediate Supervisor
Date Date
TOTAL
Purpose
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goo
services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statemen
punsihable by law.
Certified correct: Noted by:
Signature
Printed Name ALYSSA D. TULIAO JASSEL S. TAMAYAO, CPA
Employee Immediate Supervisor
Date Date
NTER
NG RECEIPTS
ne 19, 2017
AMOUNT (Php)
50.00
150.00
150.00
50.00
400.00
Noted by:
NTER
NG RECEIPTS
ne 19, 2017
AMOUNT (Php)
50.00
150.00
150.00
50.00
400.00
Noted by: