Appendix 32

Republic of the Philippines Fund Cluster :

Department of Education
Region V
DIVISION OF MASBATE
Masbate City
Date :
DISBURSEMENT VOUCHER
DV No. :

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

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee 0

Address BADIANG, CATAINGAN, MASBATE

Responsibility
Particulars MFO/PAP Amount
Center
To request reimbursement oft the expenses incurred in the procurement of
plaques for the resource person during Upscaling of Non-Teaching
Personnel on Core Skills and Behavioral Competencies Batch 2
(Reimagining Healthy Work Environment)” as per supporting papers 1,170.00
hereto attached in the amount of…

Amount Due 1,170.00

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

MARK ANTHONY H. RUPA

Chief ES, SGOD
Printed Name, Designation and Signature of Supervisor

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)

S
proper

Signature Signature

Printed
Printed Name
Name ROMEO T. ATACADOR NENE R. MERIOLES, CESO V
Position Accountant III Position Schools Division Superintendent

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
 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Masbate

Sir/Madam:

Please lquote your lowest prices for the supplies/materials listed below to be delivered to the
Office of the , subject to the usual inspection by the
or his authorized representative.

Quotation shall be construed to mean that the bidder guarantees, to furnish the supplies/materials and
fully conforming to the specifications and to abide by the terms and conditions, government taxes, imports and/or
duties, if any and all incidental expenses.

When the invitation to bid calls for more than one item, quotations are to be individually treated and
the bidder shall be compelled to accept the awards of which items may be selected by the government. An all
non-offer, however, may be considered and the discretion of

The government reserves the right to reject any of all bid prices offered, to waive any defect or to
accept such prices as may be found advantageous to the government.

Very truly yours,

BAC CHAIRMAN

I HEREBY QUOTE the following

QTY. UNIT ARTICLES Unit Price TOTAL
5 pax Plaque
7 pax plaque

Signature
 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Masbate

Sir/Madam:

Please lquote your lowest prices for the supplies/materials listed below to be delivered to the
Office of the , subject to the usual inspection by the
or his authorized representative.

Quotation shall be construed to mean that the bidder guarantees, to furnish the supplies/materials and
fully conforming to the specifications and to abide by the terms and conditions, government taxes, imports and/or
duties, if any and all incidental expenses.

When the invitation to bid calls for more than one item, quotations are to be individually treated and
the bidder shall be compelled to accept the awards of which items may be selected by the government. An all
non-offer, however, may be considered and the discretion of

The government reserves the right to reject any of all bid prices offered, to waive any defect or to
accept such prices as may be found advantageous to the government.

Very truly yours,

BAC CHAIRMAN

I HEREBY QUOTE the following

QTY. UNIT ARTICLES Unit Price TOTAL

Signature
 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Masbate

Sir/Madam:

Please lquote your lowest prices for the supplies/materials listed below to be delivered to the
Office of the , subject to the usual inspection by the
or his authorized representative.

Quotation shall be construed to mean that the bidder guarantees, to furnish the supplies/materials and
fully conforming to the specifications and to abide by the terms and conditions, government taxes, imports and/or
duties, if any and all incidental expenses.

When the invitation to bid calls for more than one item, quotations are to be individually treated and
the bidder shall be compelled to accept the awards of which items may be selected by the government. An all
non-offer, however, may be considered and the discretion of

The government reserves the right to reject any of all bid prices offered, to waive any defect or to
accept such prices as may be found advantageous to the government.

Very truly yours,

BAC CHAIRMAN

I HEREBY QUOTE the following

QTY. UNIT ARTICLES Unit Price TOTAL

Signature
 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Masbate

Date
JOB ORDER No. ____________

NENE R. MERIOLES, CESO V

Schools Division Superintendent

Madam:

Printing of 3 pcs of 3x5 Tarpaulin

Section where work to be done:

Requested by:

MARK ANTHONY H. RUPA

CHIEF, SGOD

Date

Total Estimate Cost: 1,200.00

Materials
Labor
Exception:

Certified Correct:

VIRGINIA C. PUNAY
Supply Officer

Approved:
NENE R. MERIOLES, CESO V
Schools Division Superintendent
 Department of Education
SDO- Masbate Province
DATE:_______
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
pc Gift Cert for Best Men& Women i Err:509 875 7,000.00
pc Gift Cert for Best Men & Women 13 0 -

CHRISTOPHER I. ALVAREZ VIRGINIA C. PUNAY

Printed Name of Requisitioner Administrative Officer V/Supply Officer

Approved: Received by:

NENE R. MERIOLES, CESO V
Schools Division Superintendent Signature of Requisitioner
 Department of Education
DIVISION OF MASBATE
Masbate

NAME: Position:
SALARY: Station:
PURPOSE OF TRAVEL:

ITINERARY OF TRAVEL

TIME ALLOTMENT EXPENSES

Name of
DATE Place to be Visited Transportation Trans- TOTAL AMOUNT
Departure Arrival Per Diem
portation Fee

TOTAL - - -
I hereby certify that: (1) I have reviewed the
foregoing itinerary, (2) the travel is necessary to the
service, (3) the period covered is reasonable and
(4) the expenses claimed are proper. Official/Employee

Bookkeeper-Designate PSDS/Principal/School Head

 CERTIFICATE OF DELIVERY

To Whom It May Concern:

I HEREBY CERTIFY that all articles on this voucher have been delivered to the office of the
_________________________________Masbate, delivered by __________________________under contrac
or Verbal ___________________________ to measurement as listed herein; that all of said articles
(except as otherwise specifically noted on the voucher) as new and first hand; and that accordingly
they have been accepted by me in my capacity as Supply officer II of the office of the Department of Educatio
for and behalf of the Schools Division Superintendent, Masbate and that the contractor
or dealer is entitled to payment therefore.

School Property Officer- Designated

Principal/School Head
Dated:_______________,20_____
bate, delivered by __________________________under contract

ty as Supply officer II of the office of the Department of Education

 Republic of the Philippines
Department of Education
DIVISION OF MASBATE
District: ____________________________
School: ________________________________
Project: ________________________________

PROGRAM OF WORK

UNIT QTY Description Unit Cost Total Cost

Total:____________________________________
Labor:____________________________________
Total Cost:_________________________________

Prepared:
_______________________
School Property -Designate

Certified Correct:
_______________________
Bookkeeper-Designate

Approved:
__________________________
Principal/ School Head
ABSTRACT OF CANVASS FOR FURNISHING AND DELIVERING SUPPLY MATERIALS FOR THE OFFICE OF THE SCHOOLS DIVISION
SUPERINTENDENT FOR MASBATE
ITEM QTY. NAME OF BIDDERS Previous Accepted
Unit ARTICLES
NO. Rolando Abayon Brian Araneta Josie Mahinay Price Price
01 kg 8 dried squid 875.00 7,040.00 895.00 875.00
02
03

___________________________________ _______________________________ ___________________________________

School Property Designate Inspector Designate Bookkeeper Designate

AWARD TO:
______________________________________ _________________________________
Signature Over Printed Name of Supplier Principal / School Head
 Republic of the Philippines
Department of Education
DIVISION OF MASBATE
Masbate

PAYROLL for Transportation Expenses for___________________________________________________

NAME AMOUNT RECEIVED GRADE LEVEL SIGNATURES

Total

Prepared By: Certified Correct:

School Property- Designate Bookkeeper - Designate

Approved:

Principal/School Head
 Republic of the Philippines
Department of Education
DIVISION OF MASBATE
Masbate

Pupose : Breakdown Expenses for the Contestant________________________________________________________

TIME Means of Transportation

PLACES TO BE VISITED MEALS AMOUNT
DEPARTURE ARRIVAL Transportation Exp./ Fee

Total

Prepared By: Certified Correct:

_____________________
School Property - Designate Bookkeeper - Designate

Approved:

Principal/School Head
 Republika ng Pilipinas
Kagawaran ng Edukasyon
Region V
DIVISION OF MASBATE
Masbate

ACKNOWLEDGEMENT RECEIPT

This is to acknowledge receipt of the amount of Nineteen Thousand and Forty Pesos Only
( P19,040.00) from DepEd Masbate Province as payment for the spa services for women employees of SDO Masbate.
(CERTIFIED TRUE COPY and VERIFIED TRUE COPY FROM THE ORIGINAL COPY SUBMITTED)

_____________________________________________________________________________________________

_________________________________________
Signature Over Printed Name of Payee

___________________________________ ____________________________________
Signature Over Printed Name of Witness Signature Over Printed Name of Witness
 REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF EDUCATION
REGION V
DIVISION OF MASBATE

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001- dated June 19, 2017
Employee
Name of Employee
No.
Office
Division
Particulars Amount (₱)

TOTAL
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 punishable by law.
Certified Correct: Noted By:
Signature:

Printed Name:

Employee Immediate Supervisor

Date Date
 Particulars Percentage
Day of Arrival at point of 100%
destination (regardless of time)
and succeeding day/s thereof
on official business

Day of departure for 50%

permanent official station
(regardless of time) if other
than date of travel
 To Cover
50% - Hotel /Loging
30% - Meals
20% - Incidental Expesnses

30% - Meals
20% - Incidental Expesnses
 CASH/CHECK DISBURSEMENTS REGISTER
Entity Name: Name of Accountable Officer:
Sub-Office/District/Division: Official Designation:
Municipality/City/Province: Station:
Fund Cluster Register No.:
Sheet No.:
Operating Expenses
(19901010)
Other
Office Supplies Travel
Supplies and Expenses - FIDELITY RM- School
Amount Expenses Materials Local Electricity BOND Bldng. OTHERS
UACS
DV/Payroll/ Object
Date Check No. Particulars Cash Advance Payments Balance (50203010) (50203990) (50201010) (50204020)(50215020-00)(50213040-03) Account Description Code Amount
Balance of Previous MOOE Cash Advance 5,000.00
New Release of MOOE Cash Advance 20,000.00
Total Available MOOE 25,000.00
1/6/2020 123 Reimbursement of SCHOOL HEAD 1,900.00 23,100.00 300.00 500.00 1,100.00
2/6/2020 124 MASELCO 3,000.00 20,100.00 3,000.00
3/6/2020 125 MCE OFFICE SUPPLIES 5,760.00 14,340.00 6,000.00 Due to BIR (Debit to Account) 20201010-00 240.00
7/6/2020 126 FEDILITY BOND 5,000.00 9,340.00 5,000.00
8/6/2020 127 SONIA ANG HARDWARE 7,000.00 2,340.00 7,000.00 Due to BIR (PAYABLES) 20201010-00 375.00

SUMMARY:
Cr. Advances to Officers & Employees 19901010-00 5,000.00
Cr. Advances to Officers & Employees 19901010-00 17,660.00
Cr. Due to BIR 20201010-00 240.00
Total Credits 22,900.00
100.00% of Liquidation (Previous)
Totals 22,660.00 2,340.00 300.00 6,500.00 1,100.00 3,000.00 5,000.00 7,000.00 88.30% of Liquidation (New)
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: RECEIVED / REVIEWED BY: APPROVED BY:

Signature over Printed Name Signature over Printed Name ROMEO T. ATACADOR
School Head MOOE EXPRESS Bookkeeper Accountant III
Date: ___________________ Date: ____________________ Date: ______________
 MONTHLY CASH PROGRAM
FY 2020

SCHOOL : ____________________________
STATION: DepEd, MASBATE
Fund: M O O E 2020 Note: Monthly release of allotment : TOTAL 90,000.00

ACCOUNT TOTAL
PARTICULARS CODE CASH JAN FEB MAR APRIL MAY JUNE JULY AUG SEP OCT NOV DEC
PROGRAM
ALLOTMENT :

LESS:
CA ADVANCE :

Traveling Expenses-Local 50201010-00 8,000.0000 5,000.0000 2,000.0000 1,000.0000

Training Expeses 50202010-00
Office Supplies Expenses 50203010-00 12,000.00 6,000.00 4,000.00 2,000.0000
Medical, Dental and Lab. Supplies Exp. 50203080-00
Drugs and Medicines Inventory 10404060-00
Fuel, Oil, and Lubricants Expenses 50203090-00
Other Supplies and Materials Expenses 50203990-00
Water Expenses 50204010-00
Electricity Expenses 50204020-00
Postage and Countries Expenses 50205010-00
Internet Subscription Expenses 50205020-02
Survey Expenses 50207010-00
Telephone - Mobile Expenses 50205020-01
Other General Services 50212990-00
Repairs & Maintenance - Office Equipment 50213050-02
Repairs & Maintenance - Other Structure 50213040-99
Repairs & Maintenance - School Buildings 50213040-03
Repairs & Maintenance - ICT Equipment 50213050-03
fidelity Bond 50215020-00
Printing Publication Expenses 50299020-02
Transportation and Delivery Expenses 50299040-00

TOTAL 90,000.00

Prepared by:

Principal / Head Teacher / TIC

 NEW CODES FOR MOOE DOWNLOADING
Traveling Expenses-Local 50201010-00
Training Expeses 50202010-00
Office Supplies Expenses 50203010-00
Medical, Dental and Lab. Supplies Exp. 50203080-00
Drugs and Medicines Expenses 10404060-00
Fuel, Oil, and Lubricants Expenses 50203090-00
Other Supplies and Materials Expenses 50203990-00
Water Expenses 50204010-00
Electricity Expenses 50204020-00
Postage and Countries Expenses 50205010-00
Internet Subscription Expenses 50205020-02
Survey Expenses 50207010-00
Telephone Expenses-Mobile 50205020-01
Other General Services 50212990-00
Repairs & Maintenance - Office Equipment 50213050-02
Repairs & Maintenance - Other Structure 50213040-99
Repairs & Maintenance - School Buildings 50213040-03
Repairs & Maintenance - ICT Equipment 50213050-03
Legal Services 50211010-00
fidelity Bond 50215020-00
Printing Publication Expenses 50299020-02
Transportation and Delivery Expenses 50299040-00
 Department of Education
DIVISION OF MASBATE
Masbate

CERTIFICATE OF TRAVEL COMPLETED

Agency Head: NENE R. MERIOLES, CESO V Station: DepEd, Division of Masbate

Position: SCHOOLS DIVISION SUPERINTENDENT Date:

I certify that I have completed the travel authorized in itinerary of Travel No. _______________
dated June 7-10, 2016 under conditions indicated below:

Strictly in accordance with the approved itinerary. Cut short as explained

below. Excess payment in the amount of P _______________________
was refunded under O.R. No. _____________ dated ______________. Extended as
explained below, additional itinerary was submitted. Other deviation as
explained below.

Explanation or justification:

Evidence of travel:
( ) Used tickets ( ) Certificate of Appearance ( ) Others
( )

Respectfully submitted:

CHRISTOPHER I. ALVAREZ
Official/Employee

On evidence and information of which I have knowledge, the travel

was actually undertaken.

MARK ANTHONY H. RUPA

Immediate Supervisor
 For the p

Entity Name : ________________________________

Fund Cluster : _______________________________
We acknowledge receipt of cash shown opposite our name as full compensation for services rendered for the p

Serial
Name Position Employee No.
No.
94

A CERTIFIED: Services duly rendered as stated.

Signature over Printed Name of Authorized Official

B CERTIFIED: Supporting documents complete and proper; and cash available in the amount of
P______________________.

(Signature over Printed Name)

Head of Accounting Division/Unit
 PAYROLL
For the period _______________

Payroll No. : _______________

Sheet _________of __________
ation for services rendered for the period covered.

COMPENSATIONS DEDUCTIONS

Gross
Salaries and Total
Amount
Wages-Regular Deductions
Earned

C APPROVED FOR PAYMENT: __________________________________________

________________________________________________________________

Date (Signature over Printed Name)

Head of Agency/Authorized
Representative

cash available in the amount of D CERTIFIED: Each employee whose name appears on the payroll
has been paid the amount as indicated opposite his/her name

Date (Signature over Printed Name)

Disbursing Officer
 Appendix 33

roll No. : _______________________

et _________of __________Sheets

Net Amount
Signature of Recipient
Due

______________________________________________
___________________________(P )

Date

s on the payroll E
s/her name ORS/BURS No. : _______________
Date : ____________________
JEV No. : _____________________
Date : ____________________
 Appendix 46
REIMBURSEMENT EXPENSE RECEIPT

Entity Name: _________________ Fund Cluster : ________________

Date : _______________________ RER No. : ___________________

RECEIVED from ______________________________________

(Name)
_________________________________________________ the amount
(Official Designation)
of __________________________________________ (P__________)
(In Words) (in Figures)
in payment for _______________________________________________
(Payments for subsistence, services,
_________________________________________________________
rental or transportation should show inclusive dates,
_________________________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Signature __________________________________________
Address ________________________________________________

WITNESS
Name/Signature __________________________________________
Address ________________________________________________

REIMBURSEMENT EXPENSE RECEIPT

Entity Name: _________________ Fund Cluster : ________________

Date : _______________________ RER No. : ___________________

RECEIVED from ______________________________________

(Name)
_________________________________________________ the amount
(Official Designation)
of __________________________________________ (P__________)
(In Words) (in Figures)
in payment for _______________________________________________
(Payments for subsistence, services,
_________________________________________________________
rental or transportation should show inclusive dates,
_________________________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Signature __________________________________________
Address ________________________________________________

WITNESS
Name/Signature __________________________________________
Address ________________________________________________
 Appendix 59

INVENTORY CUSTODIAN SLIP

Entity Name: ___

DEPED MASBATE
Fund Cluster : ________________________________ ICS No : ____________

Amount
Inventory Estimated
Quantity Unit Total Description
Unit Cost Item No. Useful Life
Cost
1 pc 500 500 tarpualin 3x6

Received from: Received by:

MARIA THERESA A. BASAS CHRISTOPHER I. ALVAREZ

Signature Over Printed Name Signature Over Printed Name
AO IV, Supply Section EPS II, HRDS
Position/Office Position/Office
__________________________________ ______________________________
Date Date
 Appendix 60

PURCHASE REQUEST

Entity Name: ____ DEPED MASBATE Fund Cluster: __________________

Office/Section : _____________ PR No.: ______________ Date: ____________
_________________________ Responsibility Center Code : ___________
Stock/ Property
Unit Item Description Quantity Unit Cost Total Cost
No.
pc Gift Cert for Best Men& Women in Purp 9 500.00 4,500.00
pc Gift Cert for Best Men & Women in Pur 13 200.00 2,600.00

7,100.00
Purpose:

for 2023 Women's Month Celebration

Requested by: Approved by:
Signature : _________________________ ___________________________
Printed Name : CHRISTOPHER I. ALVAREZ NENE R. MERIOLES, CESO V
Designation : EPS II, HRDS Schools Division Superintendent
 Appendix 61

PURCHASE ORDER
DEPED MASBATE
Entity Name

Supplier : Wishbone Internet services P.O. No. : ____________________________

Address : Masbate City Date : _______________________________
TIN : ________________________________________________ Mode of Procurement :
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:

Place of Delivery : ________ SDO- Masbate Province Delivery Term : ________________________

Date of Delivery : __________ 20-Dec-21 Payment Term :
Stock/
Unit Description Quantity Unit Cost Amount
Property No.
kg dried squid 8 875.00 7,000.00
-
-
Plaque -
-
-
-
-
-
-
-
-
-
pc

7,000.00
(Total Amount in Words) Seven Thousand Pesos

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 on the undelivered item/s.

Conforme: Very truly yours,

__________________________ NENE R. MERIOLES, CESO V

Signature over Printed Name of Supplier Schools Division Superintendent
___________________________
Date

Fund Cluster : ___________________________________ ORS/BURS No. : ______________________

Funds Available : _________________________________ Date of the ORS/BURS: _______________
________________________________________ Amount : ____________________________
Signature over Printed Name of Bookkeeper
 Appendix 62

INSPECTION AND ACCEPTANCE REPORT

Entity Name : __ DEPED MASBATE PROVINCE Fund Cluster : ___________

Supplier : LCC Supermarket IAR No. : _______________

PO No./Date : ___________________________________________ Date : _________________
Requisitioning Office/Dept. : _______________________________ Invoice No. : ____________
Responsibility Center Code : _______________________________ Date : _________________

Stock/
Description Unit Quantity
Property No.
Gift Cheque pc
pc

INSPECTION ACCEPTANCE
Date Inspected : ________________________ Date Received : _____________________

Inspected, verified and found in order as to Complete

quantity and specifications
Partial (pls. specify quantity)
RONALD E. ESCANDOR
Chairman, Inspectorate Team
MARIA THERESA A. BASAS
EDGAR ALLAN T. CAHILIG SALVE G. TEMBLOR AO IV, Supply Section
Member Member
 Appendix 63

REQUISITION AND ISSUE SLIP

Entity Name : ____ DEPED MASBATE Fund Cluster : ________________

Division : _______ MASBATE PROVINCE Responsibility Center Code : ____________
Office : ________________________________________________ RIS No. : ______________________________
Requisition Stock Available? Issue
Stock No. Unit Description Quantity Yes No Quantity Remarks
pc Gift Cert for Best Men& Women in Purple 9 /
pc Gift Cert for Best Men & Women in Purple 13 /
Manicure & Pedicure w/ Footspa 21 /
Plaque 6 6
Decoration Services for the FF:
1. Photobooth for Women's Day
2. Kick Off Ceremony Day
3. Gawad Dayaw
White stick 21 /
balloons S1412 1 /
Foil Balloons 1 /
Foil Balloons 1 /
Toys Stick with balloons 1 /
pc Plaque 1 /
pc Tote Bag 180 /
pc Tarpaulin 4x8 1 /
pc Marble cake (size 9) 1 /
pc Tote Bag 50 /
pc Tarpaulin 3x6 1 /
pcs Certificate Holders 30
pc Bouquet 2
pc Bouquet 1
Manicure - Pedicure 20 /
Foot Massage 20 /
Haircut 10 /
Clean Up Brow 6 /
Eyelash Extension 22
Mani , Pedi , Footspa & Foot whitening 20
Mani , Pedi w/ imported polish 25
Hair color 1
cake 21
pc Certificate Holders 20
pcs ID lace lanyard 40 /
Gift Cheque 14
pc Palmolive ints MS 1
pc Alcoplus Isopr 1
pc Unique TP Meteor 1
pc Farlin baby wipes 1
pcs Bioderm soap cool 2
pcs Johnson powder milk 1
pcs Bestant sando bag yellow 3
pcs Sister SLK 8+8 Fr 2
pc Farlin baby wipes 1 /
pc Palmolive ints 15 ml 1
pcs Bioderm soap cool 2
pc Palmolive grn 1
pcs creamsilk 2
pc Alcoplus Isopr 1
pc Johnson powder 1
pc Unique TP Metior 1
pcs Sister IK 2
pc Farlin baby wipes 1
pcs Creamsilk conditioner 2
pc Palmolive green 1
pc Palmolive Ints MS 1
pc Unique TP meteor 1
pcs Bioderm soap cool 2
pc Alcoplus Isopr 1
pc Johnson powder milk 1
pcs Creamsilk conditioner 2
pcs Sister SLK 2
pc Palmolive green 1
pc Alcoplus Isopr 1
pc Johnson Powder milk 1
pcs Creamsilk 2
pcs Sister SLK 2
pc Palmolive green 1
pc Greatbuys PC 6.5 1
pcs Cube Vanilla Fudge 25 4
pc Susan Baker Ceylon Tea 1
pcs Oishi Bread Pan Butter 3
pcs Eggnog Cookies 130g 2
pc Oishi Bread Pan Toaste 1
pcs Bread Stix Family 130g 2
pc JRJ Coffee Strirrer 1
pc JRJ Kikiam Tray 25's 2
pc Kopiko Café Blanca 1

Purpose:

for 2023 Women's Month Celebration

Requested by: Approved by: Issued by: Received by:
Signature :
Printed Name : CHRISTOPHER I. ALVAREZ MARIA THERESA A. BASAS GENALYN O. METANTE CHRISTOPHER I. ALVAREZ
Designation : EPS II, HRDS AO IV, Supply Section Adm. Assistant III EPS II, HRDS
Date :
 WASTE MATERIALS REPORT

Entity Name : ___________________________ Fund Cluster : _____________________

Place of Storage : ___________________________________________ Date : ________________________________
ITEMS FOR DISPOSAL
Record of Sales
Item Quantity Unit Description Official Receipt
No. Date
1
2
3
4
5
6
7
8
9
10
TOTAL
Certified Correct : Disposal Approved :
_________________________________
Signature over Printed Name of Signature over Printed Name of Head
Supply and/or Property Custodian Agency/Entity or his/her Authorized
Representative
CERTIFICATE OF INSPECTION

I hereby certify that the property enumerated above was disposed of as follows:

Item ________ Destroyed

Item ________ Sold at private sale
Item ________ Sold at public auction
Item ________ Transferred without cost to __(Name of the Agency/Entity)__

Certified Correct:
Signature over Printed Name of InspectionWitness to Disposal:
Officer Signature over Printed Name of Witne
 Appendix 65

__________________
____________________

ord of Sales
icial Receipt
Amount

_____________________
Printed Name of Head of
or his/her Authorized
presentative

Printed Name of Witness

 PROPERTY ACKNOWLEDGMENT RECEIPT

Entity Name : __________________________________

Fund Cluster: _____________________________________ PAR No.: _________________

Property Date
Quantity Unit Description
Number Acquired

Received by: Issued by:

_________________________________________ __________________________________________
Signatue over Printed Name of Supply and/or
Signatue over Printed Name of End User
Property Custodian
__________________________________ _______________________________
Position/Office Position/Office
_________________________ _________________________
Date Date
 Appendix 71

EIPT

R No.: _________________

Amount

__________________________
inted Name of Supply and/or
perty Custodian
 ____________________
osition/Office
__________________
Date