Municipality of Maria Aurora

Province of Aurora
CERTIFICATION ON APPROPRIATIONS, FUNDS AND OBLIGATION OF ALLOTMENT
Request Obligation no:
Payee: ESTELA DOMINGO Approved Amount: PhP 3,000.00
Function Allotment Class Expense Code Amount Certification:
I hereby certify as to the existence of appropriations for the

3,000.00 expenditures in the amount specified herein:

TERESITA D. MAPUYAN
Municipal Budget Officer Date
Total Amount requested Php PhP 3,000.00 Certification:
Amount in words: THREE THOUSAND I hereby certify as to the availability of funds for the
PESOS ONLY expenditures in the specified herein:

Requesting Official:
AUREA R. DIAZ
Municipal Treasurer Date
ELENA D. GONZALES AMADO M. GENETA Certification:
MSWDO Municipal Mayor Date I hereby certify
-

GRACE ASHLEY B. PADUA Date

Municipal Accountant
Subsidiary Ledger
Date Particular Reference Liquidation Obligation Increase(decrease) Balance
 DISBURSEMENT VOUCHER GENERAL FUND
Municipality of Maria Aurora, Aurora DV NO:
Date:
ID No./ TIN:
Payee: ESTELA DOMINGO CAFOA NO:
Address: BarangayBAUBO, Maria Aurora,Auroa Responsibility Center:

Particulars Amount
Payment of MEDICAL Assistance as per attached supporting papers amounting to……. 3,000.00
Amount Due PHP 3,000.00
A Certified: B Certified: C Certified:
Expenses/Cash Advances Necessary, Completeness and propriety of supporting Funds available for the purpose.
valid, proper, lawful and incurred under documents/previous cash advance
my direct supervision liquidated/existence of fun held in trust

ELENA D. GONZALES GRACE ASHLEY B. PADUA AUREA R. DIAZ

Head of the Department or Office Municipal Accountant Head of Treasury Department/ Office
D Approved For Payment: E E Received Payment:
P 3,000.00 Payment:
Check no.
Bank No. DBP Baler ESTELA DOMINGO
AMADO M. GENETA Date: Signature Over Printed Name/ Position
Local Chief Executive Date : ______________
F Accounting Entries
Particulars Account Code Debit Credit

Prepared by: Certified Correct:

JESSICA H. SAN JUAN GRACE ASHLEY B. PADUA
Accounting Personnel Head. Accounting DivisionUnit
 CERTIFICATE OF ELEGIBILITY

This is to certify that ES risiding at Brgy. DIAAT

Maria Aurora, Aurora, has been found eligible for MEDICAL Assistance after interview and the
case study had been made.

Record of the Case Study for Assistance in the amount of FOUR THOUSAND
PESOS ONLY( Php 4,000.00 ).

Prepared by:
Noted by:
JANINE G. GONZALES
ELENA D. GONZALES Administrative Aide
MSWDO

CERTIFICATE OF ELEGIBILITY

This is to certify that ES risiding at Brgy. DEBUCAO

Maria Aurora, Aurora, has been found eligible for MEDICAL Assistance after interview and the
case study had been made.

Record of the Case Study for Assistance in the amount of FOUR THOUSAND
PESOS ONLY( Php 4,000.00 ).

Prepared by:
Noted by:
JANINE G. GONZALES
ELENA D. GONZALES Administrative Aide
MSWDO
 SOCIAL CASE STUDY REPORT

March 18, 2021

Date
I. IDENTIFYING INFORMATION:

Name : JASMIN V. TIDALGO

Age : 47 Civil Status MARRIED 4P's (YES) (NO) /
Address : Brgy. CABITUCULAN EAST, Maria Aurora, Aurora
Occupation : HOUSEWIFE

II. FAMILY COMPOSITION:

NAME Relationship Age Sex Educational Attainment Occupation

1 RODRIGO FERNANDEZ HUBAND 67 M HIGH SCHOOL GRADUATE FARM LABORER
2 JERRY FERNANDEZ SON 18 M SUBJECT OF THE CASE ISY
3 JOHN ANDREI FERNANDEZ SON 17 M GRADE 7 ISY
4
5

EDUCATIONAL ASSISTANCE Php 1,000.00

IV. DIAGNOSIS OF THE SITUATION:

Client came personally in this office (MSWD) asking Educational Assistance for her son , who is presently
enrolled at Wesleyan University- Philippines as Grade 102 Client claimed that the family could not afford to
support all educational expenses needed, Hence, MSWD assistance is really needed.

V. RECOMMENDATION:

Client is highly recommended to avail Educational Assistance amounting to ONE THOUSAND PESOS
ONLY ( Php 1,000.00 ).

Prepared by:

Noted: MAYNARD F. MIANA

Administrative Aide
ELENA D. GONZALES
MSWDO APPROVED:

AMADO M. GENETA
Municipal Mayor
 Mount Carmel High School of Maria Aurora

Client and family valued education so much that's why, despite of simpleness and hardship in life client has th
helped each other just to support the educational needs of school ages children. Family's source of income is through
support the basic needs of the family hence, social intervention is very much needed to ease their burden.
life client has the strong determination to pursue her study. Parent
me is through ice cream vendor with such income is just enough to
en.
 SOCIAL CASE STUDY
August 28, 2021
Date
I. IDENTIFYING INFORMATION:

Name : MARITESS B. GUROBAT

Age : 40 Civil Status MARRIED 4P's (YES) (NO) /
Address : Brgy. Dialatnan, Maria Aurora, Aurora
Occupation : HOUSEWIFE / SUBJECT OF THE CASE

II. FAMILY COMPOSITION:

NAME Relationship Age Sex Educational Attainment Occupation

1 JOSEPH T. GUROBAT HUSBAND 46 M HS GRADUATE BRGY. OFFICIAL
2 MAUREEN GUROBAT DAUGHTER 18 F
3 MARK JOSEPH GUROBAT SON 11 M GRADE 6
4
5

III. PROBLEM PRESENTED:

MEDICAL ASSISTANCE Php 1,500.00

IV. DIAGNOSIS OF THE SITUATION:

Client came personally in this office (MSWD) asking Medical Assistance for herelf , who is suffering
fromuUrinal Tract Infection, Breast Mass as diagnosed by the physician. Client claimed that the family could not
afford to support all medical expenses needed, Hence, MSWD assistance is really needed under AICS program.

V. RECOMMENDATION:

Client is highly recommended to avail medical assistance amounting ONE THOUSAND FIVE HUNDRED
PESOS ONLY (Php 1,500.00).

Prepared by:

MAYNARD F. MIANA
Noted: Administrative Aide

ELENA D. GONZALES APPROVED:

MSWDO
AMADO M. GENETA
Municipal Mayor
 SOCIAL CASE STUDY
Febuary 8, 2021
Date
I. IDENTIFYING INFORMATION:

Name : RODNEY E. ALBA

Age : 54 Civil Status WIDOW 4P's (YES) (NO) /
Address : Brgy. Bazal, Maria Aurora, Aurora
Occupation : Barbers

II. FAMILY COMPOSITION:

NAME Relationship Age Sex Educational Attainment Occupation

1 NELIA ALBA wife 48 F SUBJECT TO THE CASE
2 MELANIE MAE ALBA dauhgter 17 F GRADE 11
3
4
5
6

III. PROBLEM PRESENTED:

BURIAL ASSISTANCE Php 5,000.00

IV. DIAGNOSIS OF THE SITUATION:

Client came personally in this office (MSWD) asking Burial assistance for her wife (NELIA) who died due to
CONGESTIVE HEART FAILURE as diagnosed by the Physician. Client claimed that the family could not afford to
support all funeral expenditures needed, Hence, MSWD assistance is really needed under AICS program.

V. RECOMMENDATION:

Client is highly recommended to avail burial assistance amounting to FIVE THOUSAND PESOS ONLY (Php
5,000.00).

Prepared by:

MAYNARD F. MIANA
Noted: Administrative Aide

ELENA D. GONZALES APPROVED:

MSWDO
AMADO M. GENETA
Municipal Mayor
 SOCIAL CASE STUDY
June 23, 2021
Date
I. IDENTIFYING INFORMATION:

Name : LEVERANDO C. PUNO

Age : 40 Civil Status Married 4P's (YES) / (NO)
Address : Brgy. Villa Aurora, Maria Aurora, Aurora
Occupation : FARMER

II. FAMILY COMPOSITION:

NAME Relationship Age Sex Educational Attainment Occupation

1 LORNA PUNO WIFE 49 F ELEM UNDER GRAD HOUSEWIFE
2 REYNALDO PUNO SON 21 M ELEM UNDER GRAD FARMER
3 LORETO PUNO SON 17 M GRADE 10 ISY
4 ALWINA PUNO DAUGHTER 19 F GRADE 8 ISY
5 MARY ANN PUNO DAUGHTER 9 F GRADE 5 ISY

III. PROBLEM PRESENTED:

EMERGENCY SHELTER ASSISTANCE Php 10,000.00

IV. DIAGNOSIS OF THE SITUATION:

Client came personally in this office ( MSWD ) asking Emergency Shelter Assistance because he was a
victim of residential fire that transpired last May 5, 2021 around 11:30 am in Brgy. Villa Aurora, Maria Aurora,
Aurora . Client claimed that they dont have enough money to support all the necessary expenditures. ,Hence,
MSWD assistance is really needed under AICS program .

V. RECOMMENDATION:

Client is highly recommended to avail Emergency Shelter Assistance amounting to TEN THOUSAND
PESOS ONLY (Php 10,000.00).

Prepared by:

MAYNARD F. MIANA
Noted: Administrative Aide

ELENA D. GONZALES APPROVED:

MSWDO
AMADO M. GENETA
Municipal Mayor
Client
LEVERANDO C. PUNO