FINANCIAL EXPENSE MONITORING FORM

DATE PREPARED: May 26, 2021 SECTION / DIVISION :

ORS NUMBER: OFFICE (RO/CENRO/PENRO)
LDDAP/CHECK No.: (Cashiers Office) __________ FUND: 101
VOUCHER NUMBER:(Acctg. Office) __________

ALLOTMENT
PPA SUB-ACTIVITY PURPOSE CLASSIFICATI AMOUNT AMOUNT AMOUNT OTHERS ***
(1) (2) (3) ON REQUESTED *OBLIGATED **DISBURSED (8)
(4) (5) (6) (7)

Payment for penalty of

late remittances for the 5,329.25
month of JANUARY 2021

5,329.25

PREPARED BY: APPROVED:

MABEL C. GRASPARIL NELSON V. GOROSPE

Chief, Finance Division ARD for Management Services

Note:
Column 1-5 Shall be filled out by the end user to be approved by their respective ARD
Column 6 *To be filled out by the Budget Officer Coordinator from Finance Division
Column 7 **To be filled out by the Accounting Processor from the Finance Division
Column 8 ***To be filled out by the Budget or Accounting for other processing of claims for payments

The Expense Monitoring Form shall be submitted by the Cashier Office to the Finance Division

FINANCIAL EXPENSE MONITORING FORM

DATE PREPARED: May 26, 2021 SECTION / DIVISION :

ORS NUMBER: OFFICE (RO/CENRO/PENRO)
LDDAP/CHECK No.: (Cashiers Office) __________ FUND: 101
VOUCHER NUMBER:(Acctg. Office) __________

ALLOTMENT AMOUNT AMOUNT AMOUNT

PPA SUB-ACTIVITY PURPOSE CLASSIFICATI OTHERS ***
REQUESTED *OBLIGATED **DISBURSED
(1) (2) (3) ON (8)
(4) (5) (6) (7)

Payment for penalty of

late remittances for the 5,329.25
month of JANUARY 2021

5,329.25

PREPARED BY: APPROVED:

MABEL C. GRASPARIL NELSON V. GOROSPE

Chief, Finance Division ARD for Management Services

Note:
Column 1-5 Shall be filled out by the end user to be approved by their respective ARD
Column 6 *To be filled out by the Budget Officer Coordinator from Finance Division
Column 7 **To be filled out by the Accounting Processor from the Finance Division
Column 8 ***To be filled out by the Budget or Accounting for other processing of claims for payments

The Expense Monitoring Form shall be submitted by the Cashier Office to the Finance Division
Payment for penalty of late remittances for the month of JANUARY 2021

AMOUNT 5,329.25

PRINT

Payment for penalty of late remittances for the month of

JANUARY 2021 in the total amount of . . . . . . . . . . . . . . . . .
....