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JOURNAL ENTRY VOUCHER No.

PROVINCE OF ZAMBOANGA DEL NORTE Date:


LGU
Collection Check Disbursements Cash Disbursements Others
ACCOUNTING ENTRIES
Reponsibilit
y Center Account Amount
Accounts and Explanation PR
Code Debit Credit

Trust Fund Accountable Forms #51

Payee/Office: Provincial Treasurer


Address: Dipolog City

Approved by;
LOLITA B.DELLABA JULITO P.LADEZA
Admin.Assistant II Municipal accountant

JOURNAL ENTRY VOUCHER No.


PROVINCE OF ZAMBOANGA DEL NORTE Date:
LGU
Collection Check Disbursements CasCash Disbursements Others
ACCOUNTING ENTRIES
Reponsibilit
Account Amount
y Center Accounts and Explanation PR
Code Debit Credit

Trust Fund Accountable Forms #51

Payee/Office: Provincial Treasurer


Address: Dipolog City

Approved by;
LOLITA B.DELLABA JULITO P.LADEZA
Admin.Assistant II Municipal accountant
Republic of the Philippines
PROVINCE OF ZAMBOANGA DEL NORTE
MUNICIPALITY OF TAMPILISAN

OBLIGATION REQUEST No.:


PAYEE Jaime Barredo Jr.
OFFICE Chief of Police
ADDRESS Tampilisan Police Station
Responsibilit ACCOUN
PARTICULARS F.P.P AMOUNT
y Center T CODE
To payment of Honorarium Php ###

TOTAL Php ###


.A CERTIFIED: .B CERTIFIED:
Charges to appropriation/allotment necessary,
lawful and under my direct Existence of available appropriation
Supporting documents valid, proper and legal

Signature Signature
Printed Nam JAIME N BARREDO JR. Printed Name JOVITA C. SAMUYA
Position Chief of Police Position Municipal Budget Officer
Date 7/13/2010 Date 7/13/2010
Republic of the Philippines
PROVINCE OF ZAMBOANGA DEL NORTE
MUNICIPALITY OF TAMPILISAN

DISBURSEMENT VOUCHER No.


MODE OF Check Cash Other
PAYMENT
PAYEE Delia B. Cabilin Obligation Request No.
ADDRESS Tampilisan, ZN RESPONSIBILITY CENTER
Office/Unit/Project: Code:
AMOUNT
To payment of Honorarium as Election Officer of this ###
municipality
for the month of January - March 2011 per supporting 3,000.00
papers hereto attached.

3,000.00
A CERT. B CERTIFIED:
Allotment obligated for the pur
Funds Available
Supporting documents complete
Signatur
Signature
e
Printed OLIVIA G. Date:
Printed Name
SEVERINA M. DEYSOLONGName EBORDE
Bookkeeper II Municipal Treasurer
Position (Head,Accounting Unit/Authorized R
Position (Head,Treasury Unit/Authorized Representative)

C APPROVED FOR PAYMENT: D RECEIVED PAYMENT:

Signature Check No.:Bank Name: Date:


Printed Signature
Name ENRIQUIETA D. BOMEDIANO
Printed N Delia B. Cabilin Date:
Municipal Mayor OR. No./Other DocumeJEV No. Date:
Position (Local Chief Executive/Authorized R
FOR ACCOUNTING/PRE-AUDIT SUPPORTING DOCUMENTS FOR COMMON TRANSACTIONS
(PERSONAL SERVICES)
1 SALARIES TERMINAL LEAVE
1.a FIRST SALARY: Approved application for leave
Appointment duly approved by appointing authority Complete Service Record
Oath of Office Clearance from money,property and legal
Statement of Assets and Liabilities accountability
Copy of transmittal to CSC, if appointment is not yet attested Statement of Assets and Liabilities
Certificate of Assumption Copy of Last Appointment
Certificate of Service or Daily Time Record supported with: If due to retirement, copy of appointment
1.b Monthly regular salary: showing highest salary received, if salary
DTR and/or Punch Card under last appointment is not the highest.
Certified photocopy of log book, if no bundy clock Additional requirement in case of field employees.
Approved Request for exemption, if exempted -Clearance from office of last assignment.
Certificate of Apperance and Travel Order, if on travel RETIREMENT PAY (OPTIONAL)
Approved Application for Leave, in case of absence All under No.4
Accomplishment Report, in case of non-regular employe GSIS retirement Gratuity Adjudication
1.c Additional Requirements in case of transfer: GSIS Certificate of Clearance
Clearance from previous office OVERTIME SERVICES
Certificate of last salary received from former office Authority to render overtime
1.d PROMOTION AND SALARY DIFFERENTIALS Certificate of service or Daily Time Record
Approved appointment or notice of salary adjustment Accomplishment Report, signed by
Certificate of Service or Daily Time Record supported with: employed and the supervisor
Certificate of Assumption Other Personal Services Claims
Daily Time Record & attachments (if any)
2 COMMUTATION & MONETIZATION OF LEAVE
2.a Approved application for leave
Certification of available leave credits
Letter Request (Sick Leave)
2.b COMMUTATION
Clearance, if in excess of thirty days Reviewed by:
Medical Certificate, if sick leave or maternity leave
Marriage contract for first maternity leave.
Accounting/Pre-Audit Unit
Date:
Republic of the Philippines
PROVINCE OF ZAMBOANGA DEL NORTE
MUNICIPALITY OF TAMPILISAN

No.:
OBLIGATION REQUEST
PAYEE Delia B. Cabilin
OFFICE COMELEC
ADDRESS Tampilisan, ZN
Responsibility ACCOUNT
F.P.P AMOUN
Center CODE
Payment of Honorarium Php

TOTAL Php
.A CERTIFIED: .B CERTIFIED:
Charges to appropriation/allotment necessary,
lawful and under my direct supervision Existence of available appropriation
Supporting documents valid, proper and legal

Signature Signature
Printed Name DELIA B. CABILIN Printed Name GRACE A. GUMANSING
Position Election Officer Position Budget Officer II/OIC
Date 3/11/2011 Date v 3/11/2011

Republic of the Philippines


PROVINCE OF ZAMBOANGA DEL NORTE
MUNICIPALITY OF TAMPILISAN

No.:
OBLIGATION REQUEST
PAYEE Delia B. Cabilin
OFFICE COMELEC
ADDRESS Tampilisan, ZN

Responsibility ACCOUNT
PARTICULARS F.P.P AMOUN
Center CODE
Payment of Honorarium Php
-
-

TOTAL Php.
.A CERTIFIED: .B CERTIFIED:
Charges to appropriation/allotment necessary,
lawful and under my direct supervision Existence of available appropriation
Supporting documents valid, proper and legal

Signature Signature
Printed Name DELIA B. CABILIN Printed Name GRACE A. GUMANSING
Position Election Officer Position Budget Officer II/OIC
Date 11-Mar-11 Date 3/11/2011
NORTE

AMOUNT

3,000.00

3,000.00

nce of available appropriation

GRACE A. GUMANSING
Budget Officer II/OIC
3/11/2011

NORTE

AMOUNT

3,000.00

3,000.00

nce of available appropriation

GRACE A. GUMANSING
Budget Officer II/OIC
3/11/2011
Republic of the Philippines
PROVINCE OF ZAMBOANGA DEL NORTE
MUNICIPALITY OF TAMPILISAN
DISBURSEMENT VOUCHER
MODE OF Check Cash Other
PAYEE Provincial Treasurer
RESPONSIBILITY CENTER
ADDRESS Tampilisan, ZN
Office/Unit/Project:

To additional payment of Accountable Forms


purchased in the office of the Provincial Treasurer for use in the office
of the Municipal Treasurer this municipality per supporting papers hereto
attached in the amount of . . . . 13,090.00

Amount Paid Php.9,963.53 under Check # 12759986 dated 9-23-10 - less: 9,963.53

Balance: ### 3,126.47


A CERT. B CERTIFIED:
Allotment obligated for the purpose as indicated
Funds Available
Supporting documents complete and paper

Sign
Signature atur
e
Date: Prin Date:
Printed ted OLIVIA G.
Name Na EBORDE
JULITO P. LADEZA me
Municipal Accountant Posi Municipal Treasurer
Position (Head,Accounting Unit/Authorized Representative) tion (Head,Treasury Unit/Authorized Representative)
C APPROVED FOR PAYMENT: D RECEIVED PAYMENT:
Signature CheckBank Name: Date:
Printed Date: Signa
Name ENRIQUIETA D.BOMEDIANO PrintProvincial Treasurer
Date:
Municipal Mayor OR. No./Other Documents Date:
Position (Local Chief Executive/Authorized Representative)
FOR ACCOUNTING/PRE-AUDIT SUPPORTING DOCUMENTS FOR COMMON TRANSACTIONS
CHECKLIST: MANDATORY MINIMUM SUPPORTING DOCUMENTS FOR COMMON TRASACTIONS
(PERSONAL SERVICES)
1 SALARIES TERMINAL LEAVE
1.a FIRST SALARY: Approved application for leave
Appointment duly approved by appointing authority Complete Service Record
Oath of Office Clearance from money,property and legal
Statement of Assets and Liabilities accountability
Copy of transmittal to CSC, if appointment is not yet attested Statement of Assets and Liabilities
Certificate of Assumption Copy of Last Appointment
Certificate of Service or Daily Time Record supported with: If due to retirement, copy of appointment
1.b Monthly regular salary: showing highest salary received, if salary
DTR and/or Punch Card under last appointment is not the highest.
Certified photocopy of log book, if no bundy clock Additional requirement in case of field employees.
Approved Request for exemption, if exempted 4. -Clearance from office of last assignment.
Certificate of Apperance and Travel Order, if on travel RETIREMENT PAY (OPTIONAL)
Approved Application for Leave, in case of absence All under No.4
Accomplishment Report, in case of non-regular employee GSIS retirement Gratuity Adjudication
1.c Additional Requirements in case of transfer: 5. GSIS Certificate of Clearance
Clearance from previous office OVERTIME SERVICES
Certificate of last salary received from former office Authority to render overtime
1.d PROMOTION AND SALARY DIFFERENTIALS Certificate of service or Daily Time Record
Approved appointment or notice of salary adjustment Accomplishment Report, signed by
Certificate of Service or Daily Time Record supported with: 6. employed and the supervisor
Certificate of Assumption Other Personal Services Claims
Daily Time Record & attachments (if any)
2 COMMUTATION & MONETIZATION OF LEAVE
2.a Approved application for leave
Certification of available leave credits
Letter Request (Sick Leave)
2.b COMMUTATION
Clearance, if in excess of thirty days Reviewed by:
Medical Certificate, if sick leave or maternity leave
Marriage contract for first maternity leave.
Accounting/Pre-Audit Unit
Date:
Republic of the Philippines
PROVINCE OF ZAMBOANGA DEL NORTE
MUNICIPALITY OF TAMPILISAN

DISBURSEMENT VOUCHER
MODE OF Check Cash Other
PAYMENT
PAYEE Olivia G. Eborde
RESPONSIBILITY CENTER
ADDRESS Tampilisan, ZN
Office/Unit/Project:

To reimbursement of expenses on office supplies purchased per supporting 3,000.00


papers hereto attached.
attached.

3,000.00
A CERT. B CERTIFIED:
Allotment obligated for the purpose as indicated
Funds Available
Supporting documents complete and paper

Sign
Signature atur
e
Date: Prin Date:
Printed ted OLIVIA G.
Name Na EBORDE
JULITO P. LADEZA me
Municipal Accountant Posi Municipal Treasurer
Position (Head,Accounting Unit/Authorized Representative) tion (Head,Treasury Unit/Authorized Representative)
C APPROVED FOR PAYMENT: D RECEIVED PAYMENT:

Signature CheckBank Name: Date:


Printed Date: Signa
Name ROMEO M.JALOSJOS,JR. Print Olivia G. Eborde Date:
Municipal Mayor OR. No./Other Documents Date:
Position (Local Chief Executive/Authorized Representative)
FOR ACCOUNTING/PRE-AUDIT SUPPORTING DOCUMENTS FOR COMMON TRANSACTIONS
(PERSONAL SERVICES)
1 SALARIES TERMINAL LEAVE
1.a FIRST SALARY: Approved application for leave
Appointment duly approved by appointing authority Complete Service Record
Oath of Office Clearance from money,property and legal
Statement of Assets and Liabilities accountability
Copy of transmittal to CSC, if appointment is not yet attested Statement of Assets and Liabilities
Certificate of Assumption Copy of Last Appointment
Certificate of Service or Daily Time Record supported with: If due to retirement, copy of appointment
1.b Monthly regular salary: showing highest salary received, if salary
DTR and/or Punch Card under last appointment is not the highest.
Certified photocopy of log book, if no bundy clock Additional requirement in case of field employees.
Approved Request for exemption, if exempted -Clearance from office of last assignment.
Certificate of Apperance and Travel Order, if on t 4. RETIREMENT PAY (OPTIONAL)
Approved Application for Leave, in case of absence All under No.4
Accomplishment Report, in case of non-regular emplo GSIS retirement Gratuity Adjudication
1.c Additional Requirements in case of transfer: GSIS Certificate of Clearance
Clearance from previous office 5. OVERTIME SERVICES
Certificate of last salary received from former office Authority to render overtime
1.d PROMOTION AND SALARY DIFFERENTIALS Certificate of service or Daily Time Record
Approved appointment or notice of salary adjustment Accomplishment Report, signed by
Certificate of Service or Daily Time Record supported with: employed and the supervisor
Certificate of Assumption 6. Other Personal Services Claims
Daily Time Record & attachments (if any)
2 COMMUTATION & MONETIZATION OF LEAVE
2.a Approved application for leave
Certification of available leave credits
Letter Request (Sick Leave)
2.b COMMUTATION Reviewed by:
Clearance, if in excess of thirty days Reviewed by:
Medical Certificate, if sick leave or maternity leave Accounting/Pre-Audit Unit
Marriage contract for first maternity leave. Date:
A
C Republic of the Philippines
C PROVINCE OF ZAMBOANGA DEL NORTE
MUNICIPALITY OF TAMPILISAN
DISBURSEMENT VOUCHER
MODE
Check Cash
OF
PAYMENT TIN/Employee No.:
PAYEE BUREAU OF TREASURY
RESPONSIBILITY CENTER
ADDRESS DIPOLOG CITY Office/Unit/Project:
EXPLANATION

To payment of Bond Premiums (RENEWAL) of CYNTHIA D. ABIL as Revenue


Collection Officer II of LGU-Tampilsisan, Zamboanga del Norte, per supporting parers
hereto attached in the maount of TWO THOUSAND SIX HUNDRED TWENTY FIVE
PESOS ONLY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,625.00

TOTAL AMOUNT DUE THIS VOUCHER.. 2,625.00


A CERTIFIED: B CERTIFIED:
Allotment obligated for the purpose as indicate
Supporting documents complete and paper
Funds Available
Signatur Signatur
e e
Printed Date: Printed Date:
JULITO P. LADEZA OLIVIA G. EBORDE
Name Name
Municipal Accountant Municipal Treasurer
Position Position
(Head,Accounting Unit/Authorized Representativ (Head,Treasury Unit/Authorized Representative)
C APPROVED FOR PAYMENT:
Signatur D RECEIVED PAYMENT:
Check No.Bank Name: Date:
e
Printed Date: Signature
ENRIQUIETA D. BOMEDIANO
Name Printed Nam BUREAU OF TREASURY
Municipal Mayor OR. No./Other Documents Date:
Position (Local Chief Executive/Authorized Representative
FOR ACCOUNTING/PRE-AUDIT PERSONNEL USE ONLY:
CHECKLIST: MANDATORY MINIMUM SUPPORTING DOCUMENTS FOR COMMON TRANSACTIONS
(Maintenance & Other Operating Expenses/Capital Outlay)
I. TRAVELS 2 ALTERNATIVE MODE OF PROCURMENT
Travel Order or Memorandum by the LCE authorizing t 2.a
Approved Itinerary (Appendix A) Purchase Request
Tickets (Original) for Plane, Bus, Ships Fare or equival Purchase Order/Letter Order/Contract,duly received
Certificate of Travel Completed (Appendix B) by bidder/supplier
Certificate of Appearance (Appendix C), or its equival Certificate of Acceptance
Liquidation Report-in case of cash advance Inspection Report/Waiver of Inspection
Receipts, in case of actual travel claims Result of Test Analysis (if subject to test)
Original Invoice:
Accomplishment Report -Charge Invoice/Sales Invoice
RER (optional)-For reimb. Of expenses above P 75.00 -Delivery Receipt
II. PURCHASES Canvass sheet/price quatation
1 COMPETITIVE BIDDING: Abstract/summary of canvass
Purchase Request (PR)/RIS-Original Certificate of emergency purchase-in the absence of
Purchase Order (PO)/Letter Order (LO)/Contract, duly canvass if amount is below 1,000.00
bidder 2.b NEGOTIATED PROCUREMENT/NEGOTIATED CONTRACT
Inspection and Acceptance Report/Waiver of Inspectio Negotiated Procurement:
Original Invoice: Purchase Request
Delivery Receipt Purchase Order/Letter Order/Contract(contract)
Sales Invoice/Charge Invoice duly received by bidder/supplier
Stock Position Sheet Certificate of Authority to negotiate/enter into negotiat
Result of test analysis by proper government, if subjec contract.
Copy of Advertisement/Invitation to bid Delivery Receipt
Bidder's Bond Sales Invoice/Original Invoice
Notice/Letter of Award Certificate of Acceptance & Inspection Report
Performance Bond Result of Test Analysis (if subject to test)
Abstract of Bids supported by: Certificate of failure of bidding for the second time from
Bid tenders of other participants Canvass sheet/price quatation
Acceptance of bid/proposal Abstract/summary of canvass
BAC reccomendation-Award of the LCRB/HRRB to the Negotiated Contract: (in addition to the above)
TWG recommendation Notice to commence to work
negotiated

ime from BAC


CHECKLIST: MANDATORY MINIMUM SUPPORTING DOCUMENTS FOR COMMON TRANSACTIONS (continued)
(Maintenance & Other Operating Expenses/Capital Outlay)
2.b Negotiated Contract (continued)
Program of Work and Detailed Cost Estimates Inspection Report/Waiver of Inspection
Performance Bond Performance bond
Report of Accomplishment verified and certified by government Plans & Specifications
project engineer and approved by authorized official Notice to winning bidder
Inspection Report/Waiver of Inspection Certificate of Acceptance
Performance Bond Billing of Creditors
Plans & Specifications Contractor's Accreditation
Certificate of Acceptance Agnecy Estimates
Billing of Creditor Pictures of project
Contractor's Accreditation Blue-Print
Agency Estimates Evidence that contractor is duly licensed and registered
Blue-Print 3.b Subsequent/succeeding payments
Evidence that the contractor is duly licensed and Copy of previous Accomplishment Report
registered Copy of Contract
2.c REPEAT ORDER Bill of Creditor
Purchase Request Report of Accomplishment
Purchase Order/Letter Order/Contract (original) Inspection Report/Waiver of Inspection
Sales Invoice-Original Certificate of Acceptance
Certified true copy of previous PO Photocopies of previous DV & Obr.
Certified true copy of previous Sales Invoice 3.c Change or extra work order and contract price adjustment
Delivery Receipt Approved change and extra work order
Inspection Report/Waiver of Inspection Approval from proper authorities of price adjustment
Certificate of Acceptance Agency Estimates
2.d DIRECT CONTRACTING Inspection Report
Purchase Request Certificate of Acceptance
Purchase Order/Letter Order/Contract (original) Billing of Creditors
Sales Invoice-Original 3.d Price Escalation
Delivery Receipt Approved claim for price escalation
Certificate of Acceptance 3.e Retention Fee
Inspection Report/Waiver of Inspection Certificate of Final acceptance
Result of Test/Analysis by proper gov't. agency Surety bond/warranty
(if items subject to test) 3.f Mobilization
Price List/Price Quatation/Pro-Forma Invoice PO duly received by supplier
Certificate of Executive Distributorship issued Abstract of bids
bu manufactured/principal Bill of creditor
Certification from agency authorized official: Notice to commence work
No sub-dealers selling at lower prices. Certificate of commencement of work
That no suitable substitute are available Performance Bond
2.e LIMITED SOURCE BIDDING Blue Print
Purchase Order/Letter Order/Contract (original) Agency Estimates
Sales Invoice-Original Bid tender from
Delivery Receipt 3.g Final Payment
Certificate of Acceptance & Inspection Report/Waiver of InspectioCopy of previous Accomplishment Report
Invitation to Bid Bill of Creditor
Abstract of Bids Certificate of completion and final acceptance
Certification from agency authorized official: Certificate of Final acceptance
That goods procured are specialized type of goods Affidavit of contractor re-payment of laborers and materials
That goods procured are specialized type of goods Copy of Contract
List of pre-selested suppliers/consultants from GPPB Photocopies of previous DV & Obr.
or any gov't. authority.
EQUIPMENT
Same as above, depending on the mode or procurement
3 INFRASTRUCTURE
3.a Initial Payment:
Copy of Advertisement
Abstract of Bids
Bidder's Bond
Bidder's tender form Reviewed by:
Letter of Award/Acceptance of Bid/Proposal
Contract/PO (refer to Sec 37.2.3 &37.2.4 of IRR-A of RA 9184.
Program of Work and Detailed Cost Estimates
Notice to commence to work Accounting/Pre-Audit
Report of Accomplishment verified and certified by government Date:
project engineer and approved by authorized official
ued)

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