ANNEX B

Appendix 4.3
CASH DISBURSEMENTS REGISTER

Entity Name:__________________________________________ Name of AccountableOfficer:____________________________________

Sub-Office/District/Division: ____________________________ Official Designation:____________________________________________
Municipality/City/Province: _____________________________ Station:_______________________________________________________
Fund Cluster:__________________________________________ Register No.:___________________________________________________
Sheet NO.:_____________________________________________________

Advances for Operating Expenses BREAKDOWN OF PAYMENTS

DATE DV/Payroll/ Particulars Amount Other
Check No. Office Telephone
Traveling Supplies Supplies & Electricity Expenses- Cable Expenses Printing Repair- Other MOOE
Cash Advance Payments Balance Expenses Materials Expenses Expenses Buildings
Expenses Expenses Mobile

Totals

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 BY:
__________________________ __________________________
Signature over Printed Name Signature over Printed Name
Date:_____________________ Date:_____________________
 ANNEX B
Appendix 4.3
CASH DISBURSEMENTS REGISTER

Entity Name:__________________ Hinag-oman Elementary School Name of AccountableOf Ypie S. Asauro

Sub-Office/District/Division: ___ Odiongan South Official Designation: Principal - I
Municipality/City/Province: ____ Ferrol,Romblon Station:____________ Hinag-oman Elementary School
Fund Cluster:__________________ School Based Feeding Program-Third Trance Register No.:__________________________________________
Sheet NO.:____________________________________________

Advances for Operating Expenses BREAKDOWN OF PAYMENTS

DATE O.R/ RER No. Particulars Amount FOOD SUPPLIES OPERATING OTHER MOOE
Cash Advance Payments Balance EXPENSES EXPENSES

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 BY:

YPIE S.ASAURO JUSTINE G. MENORCA
Signature over Printed Name Signature over Printed Name
Date:_____________________ Date:_____________________