Republic of the Philippines

DEPARTMENT OF EDUCATION
DepED - Region III
Nueva Ecija

OBLIGATION REQUEST AND STATUS

DepED-Division of Nueva Ecija
Agency
Payee ROSIE-LYN A. GALI
Office PAITAN SUR NATIONAL HIGH SCHOOL
Address PAITAN SUR, CUYAPO , NUEVA ECIJA
Particulars

Responsibility Account Name Fund Source MFO/P.P.A.

Center

Salaries and Wages-Civilian 01101101 262003020500002

PERA 01101101 262003020500002
Retirement and Life Insurance Premiums 01101101 262003020500002
PAG-IBIG Civilian 01101101 262003020500002
PhilHealth- Civilian 01101101 262003020500002
ECIP- Civilian 01101101 262003020500002

A. Certified B. Certified
Charges to appropriation / allotment necessary, lawful Allotment available and obligated for the purpose
and under my direct supervision as indicated above
Supporting documents valid, proper and legal
Signature Signature
Printed Name RONALDO A. POZON , Ph. D., CESO V Printed Name SARAH S. REGALA
School Division Superintendent Administrative Officer V
Position Position
Head, Requesting Office/Authorized Representative Head, Budget Unit/ Authorized Representa
Date Date
C STATUS OF OBLIGATION
. Reference Amount
Date ORS No. JEV No. Obligation Payment
ON

Organizational Code (UACS): 070010803004

No.:
Date:

Account Code Amount

5010101001 3,692.32
5010301000 363.24
5010301000 443.08
5010302001 100.00
5010303001 237.50
5010304001 100.00

Total 4,936.14

able and obligated for the purpose

SARAH S. REGALA
Administrative Officer V
d, Budget Unit/ Authorized Representative

Amount
Payable Balance
 OBLIGATION REQUEST AND STATUS
DepED-Division of Nueva Ecija
Agency
Payee JOLANY M. BARTOLOME
Office PAITAN SUR NATIONAL HIGH SCHOOL
Address PAITAN SUR, CUYAPO , NUEVA ECIJA
Particulars

Responsibility Account Name Fund Source MFO/P.P.A.

Center
Financial Assistance to NGAs 1101101

A. Certified B. Certified
Charges to appropriation / allotment necessary, lawful Allotment available and obligated for the purpose
and under my direct supervision as indicated above
Supporting documents valid, proper and legal
Signature Signature
Printed Name RONALDO A. POZON , Ph. D., CESO V Printed Name SARAH S. REGALA
School Division Superintendent Administrative Officer V
Position Position
Head, Requesting Office/Authorized Representative Head, Budget Unit/ Authorized Representa
Date Date
C STATUS OF OBLIGATION
. Reference Amount
Date ORS No. JEV No. Obligation Payment
 No.:
Date:

Account Code Amount

502140200 P 575.00

Total P 575.00

able and obligated for the purpose

SARAH S. REGALA
Administrative Officer V
d, Budget Unit/ Authorized Representative

Amount
Payable Balance