ANNEX B

Appendix 43

CASH DISBURSEMENTS REGISTER

Entity Name: _______________________________________ Name of Accountable Officer: _____________________

Sub-Office/District/Division: __________________________ Official Designation: ____________________________

Municipality/City/Province: ___________________________ Station: _______________________________________

Fund Cluster : ______________________________________ Register No. : __________________________________

Sheet No. : ____________________________________

Advances for
Operating Expenses BREAKDOWN OF PAYMENTS
(19901010)
DV/Payroll/
Date Particulars Amount Salaries and Salaries and OTHERS
Check No. Office Supplies
Payments Wages - Wages -Casual/
Expenses UACS
Cash Regular Contractual Account
Balance Object Amount
Advance Description
(50101010) (50101020) (50203010) Code
117

Totals

Recapitulation:
UACS
Account Description Amount
Object Code

Total

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: ______________________

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