SK of Barangay: Poblacion

City/Municipality: Magdiwang
Province: Romblon

AC1C:

Advice of Checks Issued and Cancelled AGENCY CODE:

To: THE BANK MANAGER

Bank Account No. 00-0-01109-606-4

CHECK NO. DATE OF ISSUE PAYEE AMOUNT ALLOTMENT OBJECT CLASS FOR GSB USE ONLY
REMARKS

CANCELLED CHECK

CHECK NO. DATE ISSUED REMARKS CERTIFIED CORRECT DELIVERED BY:

_________________________ _________________________
SK CHAIRPERSON SK TREASURER