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Report of Accountability For Accountable Forms: Appendix 67

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Appendix 67

REPORT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS


For the month of August, 2021

Entity Name : DENR PENRO Laguna Fund Cluster : 01 101 101

Accountable Forms Beginning Balance Receipt Issue Ending Balance


Inclusive Serial Nos. Inclusive Serial Nos. Inclusive Serial Nos. Inclusive Serial Nos.
Name of Form Number Face Value Quantity Quantity Quantity Quantity
From To From To From To From To
A. WITH FACE VALUE

Mailing Stamp
165

1 P 1.00 59 0 1 58
2 P 5.00 62 0 8 54
3 P 12.00 3 0 2 1
4 P 17.00 36 0 18 18
5 P 45.00 2 0 2 0

CERTIFICATION

I hereby certify that the foregoing is a true statement of all accountable forms received,
issued and transferred by me during the period above-stated and that the beginning and ending balances are correct.

_________________________________________________
Signature over Printed Name of the Accountable Officer

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