Appendix 32

Republic of the Philippines Fund Cluster :

Department of Education
DIVISION OF ___________________

Name of School
Date :
DISBURSEMENT VOUCHER DV No. :

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

Payment
________________
TIN/Employee No.: ORS/BURS No.:
Payee

Address

Responsibility
Particulars MFO/PAP Amount
Center

Amount Due Php -

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

NOLI S. LACHICA
Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit
Electricity Expenses 5020402000
Due to BIR 2020101000
Advance for Operating Expenses 1990101000 -

C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable)
Sup
proper

Signature Signature

Printed
Printed Name
Name

Accountant III Schools Division Superintendent

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.

Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents

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