Annex D

MLGU’s Confirmation on the Receipt of the FY 2019 AM Fund

LGU
LOGO

LETTERHEAD OF THE LOCAL GOVERNMENT UNIT

MLGU’s Confirmation on the Receipt of the FY 2019 AM Fund

Date __________

Director ___________
DILG Regional Office __
Address

Dear Director __________:

This is to confirm the receipt of the Municipality of _______ the amount of _____________
through the Notice of ADA Issued (NADAI) No._______ dated _________________
intended for the implementation of the following project(s) under the FY 2019 LGSF-AM
Program:

No. Name of Project Allocation

1. PhP

2. PhP

3. PhP

TOTAL PhP

The said funds have been transferred from the General Fund to the Municipality’s Trust
Fund Account No._________ and recorded as Trust Fund with separate subsidiary ledger
per project. Attached are certified true copies of proof of fund transfer.

Rest assured that we are committed to implement the above project(s) in accordance with
the FY 2019 AM Guidelines No. ______, Series 2019.

Prepared by:

(Signature over Printed Name)

Municipal Treasurer

Conformed by:

(Signature over Printed Name)

Municipal Accountant

Noted by:

(Signature over Printed Name)

Local Chief Executive

Cc: DILG-PO, MLGOO