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Form 57A
Form 57A
(Bureau or Office)
(City or Province)
Municipality Province/City
5. AMOUNT OF MAXIMUM ACCOUNTABILITY/CUSTODY
₱
When extent or character of an Officer's control
Amount over funds or property cannot be inferred from the title
a) Public Funds or designation given, a full and complete statement of
(1) As Collecting Officer ₱ duties should be given above.
(2) As Disbursing Officer ₱ (Use additional sheet if necessary)
Total Amount: ₱ ₱
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Head of Agency or Office
City Mayor
Provincial Treasurer (Designation)
GENERAL FORM NO. 57(A) FIRST
(Revised March 24, 1976)
(DESIGNATION)
SECOND
Respectfully Forwarded to t
. (DATE TO BE EFFECTIVE)
}
y or Office
(designation)
SECOND INDORSEMENT
,20_____
Bond for the within mentioned position is approved and fixed in the
______________________
By Authority of the
CHAIRMAN, COMMISSION ON AUDIT