OBLIGATION REQUEST AND STATUS No.

:
Department of Education Date: 12/12/2018
Division of Iligan City Fund:
Payee : JANE L. PAGLINAWAN
Office : Iligan City East National High School - Sta. Filomena
Address : Sta. Filomena, Iligan City
Responsibility Center Particulars MFO/PAP UACS Code Amount

To obligate reimbursement of travel expense incurrred

during the "National Training of Trainers (NTOT) on
Rondalla for Music Teachers" at Cinco Niñas,
Koronadal City held on December 4 - 8, 2018 per
supporting papers hereto attached or in the amount
of ...
3,808.00

3,808.00
A. Certified: Charges to budget necessary, lawful B.
and under my direct supervision, and supporting for the purpose/adjustment necessary as
documents valid, proper and legal indicated above

Signature : Signature :
Printed Name : MELCHORA B. LECTOR, Ph. D. Printed Name : JOHN ANTHONY C. BALOS, CPA
Position : Principal II Position : Budget Officer III
Iligan City East National High School Finance Department
Head, Requesting Office/Authorized Head, Budget Unit/Authorized
Representative Representative
Date : 12/12/2018 Date :

C. STATUS OF OBLIGATION
Reference Amount
ORS/JEV/RCI/ Due and
Date Particulars Obligation Payment Not Yet Due
RADAI No. Demandable
 Republic of the Philippines
Department of Education
Region X - Northern Mindanao
DIVISION OF ILIGAN CITY
103504000
DV No.: 2018-
DISBURSEMENT VOUCHER Date: 12/12/2018
Mode of
MDS Check Commercial Check ADA Others (Please specify)
Payment
Tin/Employee No. OR/BUR No.
Payee JANE L. PAGLINAWAN TCH1-660133-2003
Responsibility Center :
Address Iligan City East National High School - Sta. Filomena, Iligan City
Office/Unit Project Code:
PARTICULARS AMOUNT
Payment of reimbursement of travel expense incurrred during the "National Training of Trainers
(NTOT) on Rondalla for Music Teachers" at Cinco Niñas, Koronadal City held on December 4 - 8, Php 3,808.00
2018 per supporting papers hereto attached or in the amount of ...
Less Withholding Tax: P /1.12 x 2%= - -
P /1.12 x 5%= -
Fund Code:
Php 3,808.00
MFO/PPA:
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

CELSO C. AFABLE, JR.

Administrative Officer V
B. Accounting Enrty:
Account Title UACS Code DEBIT CREDIT
Travel Expense 5020101000
Due to BIR 2020101000 -
Cash on National Treasury, MDS 1010404000 3,808.00
TOTAL - 3,808.00
C. Certified: D. Approved for Payment
Cash available

Subject to Authority to Debit Account (when applicable) ₱ 3,808.00

Supporting documents complete and amount claimed proper

Signature Signature

Printed Printed
MARULYN A. CANTIVEROS, CPA EMMALINDA E. DUHAYLUNGSOD, Ph.D., CESO V
Name Name
Accountant III Schools Division Superintendent
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV NO.:
Check/ Date: Bank Name & Account No.
ADA No.
2018-
Signature Date: Printed Name: Date:
12/12/2018
Official Receipt/Other Documents
Prepared by: Certified by:

ZULICA D. GIMENO MARULYN A. CANTIVEROS, CPA

Administrative Asst. III Accountant III