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Appendix 32

Department of Education Fund Cluster :


Division of Surigao del Norte 101
Date : Oct. 2016
DISBURSEMENT VOUCHER DV No. :

Mode of MDS Check Commercial Check ADA Others (Please specify)


Payment
_________________

Payee LUCIA C. PIOSANG TIN/Employee No.: ORS/BURS No.:

PLACER DISTRICT 1
Address

Responsibility
Particulars MFO/PAP Amount
Center
To cash advance SBFP of ELLAPERAL ES 266002001100000 21,600.00
2ND Tranche SY 2016-2017 in the amount of…

Amount Due 21,600.00


A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

LUCIA C. PIOSANG
District Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit
Advances for Operating Expenses 19901010 00 21,600.00
Cash in Bank- MDS, Regular 10104040 00 21,600.00
C. Certified: D. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
Supp
proper

Signature Signature

Printed
Printed Name
Name JULIET M. DUMAGUIT FIDELA M. ROSAS
Accountant III Schools Division Superintendent
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.


Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents

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