Disbursement Voucher: Division of Bukidnon

Appendix 32
Republic of the Philippines Fund Cluster :

Department of Education
DIVISION OF BUKIDNON
Sumpong, Malaybalay City
Date :
DISBURSEMENT VOUCHER DV No. :
Mode of MDS Check Commercial Check ADA Others (Please specify)

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee WILFREDO I. BALAGAS
KIBAWE NATIONAL HIGH SCHOOL
Address
NATULONGAN, KIBAWE, BUKIDNON
Responsibility
Particulars MFO/PAP Amount
Center
TO CASH ADVANCE MOOE OF

FOR 3RD QUARTER OF CY 2017 IN THE AMOUNT OF . . .
Amount Due -
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
JESNAR DEMS S. TORRES, Ph. D.

Officer-in-Charge
Office of the Schools Division Superintendent
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)
Sup
proper
Signature Signature
Printed
RANDY H. PORRAS, CPA Printed Name JESNAR DEMS S. TORRES, Ph. D.
Name
Accountant III Officer-in-Charge
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
Appendix 11
OBLIGATION REQUEST AND STATUS Serial No. : _____________________

Republic of the Philippines
DIVISION OF BUKIDNON Date : _________________________
Sumpong, Malaybalay City Fund Cluster : ___________________
Payee WILFREDO I. BALAGAS
Office KIBAWE NATIONAL HIGH SCHOOL
Address NATULONGAN, KIBAWE, BUKIDNON
UACS Object
Responsibility Center Particulars MFO/PAP Amount
Code
TO CASH ADVANCE MOOE OF

FOR 3RD QUARTER OF CY 2017 IN THE
AMOUNT OF . . .
Total
A. Certified: Charges to appropriation/alloment are B. Certified: Allotment available and obligated
necessary, lawful and under my direct supervision;and for the purpose/adjustment necessary as
supporting documents valid, proper and legal indicated above
Signature : Signature :
Printed Name: WILFREDO I. BALAGAS Printed Name: ELVIRA P. ROJAS
Position : SCHOOL PRINCIPAL I Position : Budget Officer II
Head, Requesting Office/Authorized Representative Head, Budget Division/Unit/Authorized

Representative
Date : ___________________________________ Date : ____________________________
C. STATUS OF OBLIGATION
Reference Amount
Balance
ORS/JEV/Check/ Obligation Payable Payment Due and
Date Particulars Not Yet Due
ADA/TRA No. Demandable
(a) (b) (c) (a-b) (b-c)
Appendix 32

Date :

Payment
_________________
Payee REYNALDO DELA MANCE
CAWAYAN ELEMENTARY SCHOOL
Address
CAWAYAN, LANTAPAN, BUKIDNON
Responsibility
Center
TO CASH ADVANCE 3RD QUARTER MOOE OF

FOR CY 2017 IN THE AMOUNT OF . . .
Amount Due

Officer-in-Charge

Cash available
Sup
proper
Signature Signature
Printed
RANDY H. PORRAS, CPA Printed Name JESNAR DEMS S. TORRES, Ph. D.
Name
Accountant III OIC, Schools Division Superintendent
Position Position
Date Date

ADA No. :
Signature :
=
Appendix 11

DIVISION OF BUKIDNON Date : _________________________
Payee REYNALDO DELA MANCE
Office CAWAYAN ELEMENTARY SCHOOL
Address CAWAYAN, LANTAPAN, BUKIDNON
UACS Object
Code
TO CASH ADVANCE 3RD QUARTER MOOE OF

FOR CY 2017 IN THE AMOUNT OF . . .
Total
Printed Name: REYNALDO DELA MANCE Printed Name: ELVIRA P. ROJAS
Position : SCHOOL PRINCIPAL I Position : Budget Officer II

Head, Budget Division/Unit/Authorized
Head, Requesting Office/Authorized Representative
Representative
Date : ___________________________________ Date : ____________________________
Reference Amount
Balance
(a) (b) (c) (a-b) (b-c)
Appendix 32

Date :

Payment
_________________
Payee
Address
Responsibility
Center
TO REIMBURSE the research implementation

expenses FOR THE MONTH OF __________
AMOUNTING TO. . .
Amount Due
SHAMBAEH A. USMAN, PhD.

Assistant Schools Division Superintendent/Chief, SGOD

Cash available
Sup
proper
Signature Signature
Printed
RANDY H. PORRAS, CPA Printed Name CHERRY MAE L. LIMBACO
Name
Accountant III SCHOOLS DIVISION SUPERINTENDENT

Position Position
Date Date

ADA No. :
Signature : 0
Appendix 11

DIVISION OF BUKIDNON Date :
Payee 0
Office 0
Address 0
UACS Object
Code
0.00
TO REIMBURSE the research
implementation expenses FOR THE
MONTH OF __________ AMOUNTING
TO. . .
Total 0.00
Printed Name: SHAMBAEH A. USMAN, PhD. Printed Name: ELVIRA P. ROJAS

Position : ASDS/Chief, SGOD Position : Budget Officer II
Head, Requesting Office/Authorized Representative Head, Budget Division/Unit/Authorized

Representative
Date : ___________________________________ Date : ____________________________
Reference Amount
Balance
(a) (b) (c) (a-b) (b-c)
Appendix 45
ITINERARY OF TRAVEL
Entity Name : DEPARTMENT OF EDUCATION - DIVISION OF BUKIDNON

Fund Cluster: ____________________ No.: _______________
Name : RAMON VINCENT A. TORRES Date of Travel : 4/17-20/17

Position : ADMINISTRATIVE ASSISTANT III Purpose of Travel :
Official Station : DIVISION OFFICE TO FACILITATE LIQUIDATION OF ALL FUNDS
Places to be visited TIME Means of Transpor- Per Total

Date Others
(Destination) Departure Arrival Transportation station Diem Amount
04/17/17 PUV 7.00 7.00
DIVISION OFFICE TO
MALAYBALAY CITY PUBLIC
TERMINAL
PUV 30.00 30.00

TERMINAL TO LANTAPAN
PUBLIC TERMINAL
PUV 10.00 10.00

LANTAPAN PUBLIC TERMINAL
TO LANTAPAN DISTRICT OFFICE
PUV 10.00 10.00

LANTAPAN DISTRICT OFFICE TO
PUV 30.00 30.00

TO MALAYBALAY CITY PUBLIC
TERMINAL
PUV 7.00 7.00

TERMINAL TO DIVISION OFFICE
04/18/17 PUV 7.00 7.00

DIVISION OFFICE TO
TERMINAL
PUV 30.00 30.00

PUBLIC TERMINAL
PUV 10.00 10.00

PUV 10.00 10.00

PUV 30.00 30.00

TERMINAL
PUV 7.00 7.00

04/19/17 PUV 7.00 7.00

DIVISION OFFICE TO
TERMINAL
PUV 30.00 30.00

PUBLIC TERMINAL
PUV 10.00 10.00

PUV 10.00 10.00

PUV 30.00 30.00

TERMINAL
PUV 7.00 7.00

4/20/17 PUV 7.00 7.00

DIVISION OFFICE TO
TERMINAL
PUV 30.00 30.00

PUBLIC TERMINAL
PUV 10.00 10.00

PUV 10.00 10.00

PUV 30.00 30.00

TERMINAL
PUV 7.00 7.00

TOTAL 376.00
Prepared by :
I certify that : (1) I have reviewed the foregoing RAMON VINCENT A. TORRES
itinerary, (2) the travel is necessary to the Signature over Printed Name
service, (3) the period covered is reasonable and
(4) the expenses claimed are proper.
Approved by:

Officer-in-Charge
121
Appendix 45
ITINERARY OF TRAVEL
Entity Name : DEPARTMENT OF EDUCATION - DIVISION OF BUKIDNON

Fund Cluster: ____________________ No.: _______________
Name : WOODROW WILSON B. MERIDA Date of Travel :

Position : EDUCATION PROGRAM SPECIALIST II Purpose of Travel :
Official Station : DIVISION OFFICE To serve as Adviser during the Regional Mass Training
of Senior High School Teachers
Places to be visited TIME Means of Transpor- Per Total
Date Others
(Destination) Departure Arrival Transportation tation Diem Amount
07/08/17 DIVISION OFFICE TO AGORA, CDO 120.00 160.00

4:00 AM 6:00 AM 280.00
AGORA, CDO TO HOTEL KORESCO 15.00

6:00 AM 6:20 AM 15.00
TRAINING PROPER 800.00

6/9-11/17 800.00
06/12/17 HOTEL KORESCO TO AGORA, CDO 15.00 160.00

175.00
07/20/17 AGORA, CDO TO DIVISION OFFICE 120.00

120.00
DIVISION OFFICE TO AGORA, CDO 120.00 160.00

280.00
AGORA, CDO TO HOTEL KORESCO 15.00

15.00
TRAINING PROPER 960.00

07/21-26/17 960.00
HOTEL KORESCO TO AGORA, CDO 15.00 160.00

3:40 PM 4:00 PM 175.00
AGORA, CDO TO DIVISION OFFICE 120.00

4:00 PM 6:00 PM 120.00
TOTAL 2,940.00
Prepared by :
I certify that : (1) I have reviewed the foregoing WOODROW WILSON B. MERIDA
itinerary, (2) the travel is necessary to the service, Signature over Printed Name
(3) the period covered is reasonable and (4) the
expenses claimed are proper.
Approved by:

Officer-in-Charge
121

Disbursement Voucher: Division of Bukidnon

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Appendix 32

Republic of the Philippines Fund Cluster :

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

TO CASH ADVANCE MOOE OF

JESNAR DEMS S. TORRES, Ph. D.

C. Certified: D. Approved for Payment

E. Receipt of Payment JEV No.

OBLIGATION REQUEST AND STATUS Serial No. : _____________________

Office KIBAWE NATIONAL HIGH SCHOOL

Address NATULONGAN, KIBAWE, BUKIDNON

TO CASH ADVANCE MOOE OF

Printed Name: WILFREDO I. BALAGAS Printed Name: ELVIRA P. ROJAS

Position : SCHOOL PRINCIPAL I Position : Budget Officer II

Head, Requesting Office/Authorized Representative Head, Budget Division/Unit/Authorized

Republic of the Philippines Fund Cluster :

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

TO CASH ADVANCE 3RD QUARTER MOOE OF

JESNAR DEMS S. TORRES, Ph. D.

C. Certified: D. Approved for Payment

E. Receipt of Payment JEV No.

OBLIGATION REQUEST AND STATUS Serial No. : _____________________

Office CAWAYAN ELEMENTARY SCHOOL

Address CAWAYAN, LANTAPAN, BUKIDNON

TO CASH ADVANCE 3RD QUARTER MOOE OF

Printed Name: REYNALDO DELA MANCE Printed Name: ELVIRA P. ROJAS

Position : SCHOOL PRINCIPAL I Position : Budget Officer II

Republic of the Philippines Fund Cluster :

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

TO REIMBURSE the research implementation

SHAMBAEH A. USMAN, PhD.

C. Certified: D. Approved for Payment

Accountant III SCHOOLS DIVISION SUPERINTENDENT

E. Receipt of Payment JEV No.

OBLIGATION REQUEST AND STATUS Serial No. : _____________________

Printed Name: SHAMBAEH A. USMAN, PhD. Printed Name: ELVIRA P. ROJAS

Head, Requesting Office/Authorized Representative Head, Budget Division/Unit/Authorized

Entity Name : DEPARTMENT OF EDUCATION - DIVISION OF BUKIDNON

Name : RAMON VINCENT A. TORRES Date of Travel : 4/17-20/17

Places to be visited TIME Means of Transpor- Per Total

PUV 30.00 30.00

PUV 10.00 10.00

PUV 10.00 10.00

PUV 30.00 30.00

PUV 7.00 7.00

04/18/17 PUV 7.00 7.00

PUV 30.00 30.00

PUV 10.00 10.00

PUV 10.00 10.00

PUV 30.00 30.00

PUV 7.00 7.00

04/19/17 PUV 7.00 7.00

PUV 30.00 30.00

PUV 10.00 10.00

PUV 10.00 10.00

PUV 30.00 30.00

PUV 7.00 7.00

4/20/17 PUV 7.00 7.00

PUV 30.00 30.00

PUV 10.00 10.00

PUV 10.00 10.00

PUV 30.00 30.00

PUV 7.00 7.00