Republic of the Philippines

Department of Agrarian Reform

DARPO Lanao del Norte

OBLIGATION REQUEST AND STATUS

Payee/Office: No.:
MOHAMMAD COSARY B. DATUMULOK
Date:
Address: Fund:
DARPO, Lanao del Norte
UACS Code /
Responsibility Center: Particulars MFO/PAP Expenditure Amount

To obligate payment of perdiem and transportation

allowance while out of station on official business for
the period covering the month MARCH 2021 as per
supporting papers here to attached in the amount of
…
₱8,100.00

TOTAL 8,100.00
A. Certified: Charges to appropriation/allotment necessary, lawful and B. Certified: Allotment available and
under my direct supervision; and supporting documents valid, proper obligated for the purpose/adjustment
and legal.
necessary as indicated above.
indicated above.
Signature: Signature:
Printed Name: BEVERLY FAITH T. TANGGOL Printed Na FAISAL D. MACABATO
Position: PCAO Position: Budget Officer

Date: Date:

C. STATUS OF OBLIGATION
Reference Amount
Due and
Date Particulars ORS/JEV/RCI/RADAI No. Obligation Payment Not Yet Due
Demandable
 Republic of the Philippines Fund Cluster :
Department of Agrarian Refrom
DARPO, Lanao del Norte
Date :
DISBURSEMENT VOUCHER DV No. :

Mode of Payment Commercial Check Others (Please specify)

TIN/Employee No.: ORS/BURS No.:

Payee Imelda M. Manalundong

Address DARPO, Lanao del Norte

Responsibility
Particulars MFO/PAP Amount
Center

To payment of SALARY of Imelda M. Manalundong for the month of July

1-31, 2021 in the amount of …

P 14,700.00

Amount Due P 14,700.00

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

ATTY. NIKKI MORSHIDA M. DALIDIG

ATTY V/Chief Legal Division
B.
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Approved for Payment

Cash available

Subject to Authority to Debit Account (when applica

Su
proper
Signature Signature
Printed Name APIPA U. MANALOCON Printed Name ENGR. RUSHDI A. MINDALANO
Accountant II PARPO II
Position Head, Accounting Unit/Authorized Position
Agency Head/Authorized Representative
Representative
Date Date
E. Receipt of Payment JEV No.
Date : Bank Name & Account Number:
Check/ ADA No. :
LBP/
Date : Printed Name: Imelda M. Date
Signature :
Manalundong

Official Receipt No. & Date/Other Documents

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