Appendix 32
Fund Cluster :
Balibago Elementary School
Entity Name 01
Date :
DISBURSEMENT VOUCHER DV No. :
Mode of MDS Check Commercial Check ADA Others (Please specify)
Payment _________________
TIN/Employee No.: ORS/BURS No.:
Payee MYH EXPRESS PRINT CENTER
254-266-397-000
Address B3 L38 Dao Drive Camilla Seville Habay II, Bacoor, Cavite
Particulars Responsibility Center MFO/PAP Amount
Payment for the purchased supplies (ECCD and Kilitisan ES 310400100002000 5,858.80
Progress Report Card) for the month of December 2021
in the amount of…
Amount Due 5,858.80
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
Signature:
Printed
Name: GINA A. QUIDEM
Designation:
Requesitioning Officer
B. Approved for Payment
Amount in Words five thousand eight hundred fifty eight pesos and 80/100 only
Signature
Printed Name REYNALYN S. MENDOZA
Principal I
Position
Agency Head/Authorized Representative
Date
C: Receipt of Payment JEV No.
Bank Name & Account No.:
Check/ ADA No. : Date :
LBP 002682-1055-53
Printed Name: Date
Signature : Date :
HEIDELBERT C. CACACTIN
Official Receipt No. & Date/Other Documents
Page 1 of 1
Department of Education
Region IV-A
SCHOOLS DIVISION OF BATANGAS
Batangas City
MYH EXPRESS PRINT CENTER
B3 L38 Dao Drive,Camella Seville Habay II, Bacoor, Cavite
12/12/2021
Date
Sir/ Madam:
Please quote your price for the government of the following materials or articles to be delivered
immediately at the site at work,Indicated under the proper column below the unit price of each kind
and returned in sealed envelope after signing the blank space for your signature.
Very truly yours:
REYNALYN S. MENDOZA
School Head
-
B3 L38 Dao Drive,Camella Seville Habay II,
Address
12/12/2021
Kilitisan Elementary School Date
Quilitisan, Calatagan, Batangas
Sir/Madam:
I have the honor to submit my quotation of prices of the following materials and/or articles.
QNTY Unit Item Description Amount
36 pcs ECCD-Kinder
257 pcs Progress Report Card-Grade 1-6
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
I hereby certify that the foregoing articles and/or materials of which prices are indicated above are my
bonafide stock which are available for inspection at anytime which I can deliver immediately to the govern -
ment. I further certify that unless otherwise stated the above mention articles or materials are product of
and manufactured in the Philippines or in U.S.
Very truly yours:
HEIDELBELT C. CACACTIN
CANVASSED BY:
MARIELL C. MORENO
BAC Member
DEPEDBATS-PTY-F-004/R0/05-30-2018
Department of Education
Region IV-A
SCHOOLS DIVISION OF BATANGAS
Batangas City
SOUTH STAR PRINT CENTER
Bacoor, Cavite
12/12/2021
Date
Sir/ Madam:
Please quote your price for the government of the following materials or articles to be delivered
immediately at the site at work,Indicated under the proper column below the unit price of each kind
and returned in sealed envelope after signing the blank space for your signature.
Very truly yours:
REYNALYN S. MENDOZA
School Head
-
Bacoor, Cavite
Address
12/12/2021
Kilitisan Elementary School Date
Quilitisan, Calatagan, Batangas
Sir/Madam:
I have the honor to submit my quotation of prices of the following materials and/or articles.
QNTY Unit Item Description Amount
36 pcs ECCD-Kinder
257 pcs Progress Report Card-Grade 1-6
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
I hereby certify that the foregoing articles and/or materials of which prices are indicated above are my
bonafide stock which are available for inspection at anytime which I can deliver immediately to the govern -
ment. I further certify that unless otherwise stated the above mention articles or materials are product of
and manufactured in the Philippines or in U.S.
Very truly yours:
SHERWIN CACACTIN
CANVASSED BY:
MARIELL C. MORENO
BAC Member
DEPEDBATS-PTY-F-004/R0/05-30-2018
Department of Education
Region IV-A
SCHOOLS DIVISION OF BATANGAS
Batangas City
TWILIGHT JOURNAL AND PUBLISHING
Pasay City, Metro Manila
12/12/2021
Date
Sir/ Madam:
Please quote your price for the government of the following materials or articles to be delivered
immediately at the site at work,Indicated under the proper column below the unit price of each kind
and returned in sealed envelope after signing the blank space for your signature.
Very truly yours:
REYNALYN S. MENDOZA
School Head
TWILIGHT JOURNAL AND PUBLISHING
Pasay City, Metro Manila
Address
12/12/2021
Kilitisan Elementary School Date
Quilitisan, Calatagan, Batangas
Sir/Madam:
I have the honor to submit my quotation of prices of the following materials and/or articles.
QNTY Unit Item Description Amount
36 pcs ECCD-Kinder
257 pcs Progress Report Card-Grade 1-6
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
I hereby certify that the foregoing articles and/or materials of which prices are indicated above are my
bonafide stock which are available for inspection at anytime which I can deliver immediately to the govern -
ment. I further certify that unless otherwise stated the above mention articles or materials are product of
and manufactured in the Philippines or in U.S.
Very truly yours:
MILAGROS BAGAPORO
CANVASSED BY:
MARIELL C. MORENO
BAC Member
DEPEDBATS-PTY-F-004/R0/05-30-2018
Appendix 61
PURCHASE ORDER
DepEd -Schools Division of Batangas
Entity Name
Supplier : MYH EXPRESS PRINT CENTER P.O. No. : 2021-12-015
Address : B3 L38 Dao Drive,Camella Seville Habay II, Bacoor, Cavite Date :
TIN : 254-266-397-000 Mode of Procurement : Shopping
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:
Place of Delivery : KILITISAN ELEMENTARY SCHOOL Delivery Term :Pick- up
Date of Delivery: Payment Term : Check
Stock/ Property
Unit Description Quantity Unit Cost Amount
No.
1 pcs ECCD-Kinder 36 25.00 900.00
2 pcs Progress Report Card-Grade 1-6 257 20.00 5,140.00
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - - -
- - - - -
(Total Amount in Words) Six thousand and forty pesos only. 6,040.00
In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10) of one
percent for every day of delay shall be imposed on the undelivered item/s.
Conforme: Very truly yours,
HEIDELBELT C. CACACTIN REYNALYN S. MENDOZA
Signature over Printed Name of Supplier Signature over Printed Name of Authorized Official
Principal I
Date Designation
Fund Cluster : 01 ORS/BURS No. : _________________
Funds Available : Date of the ORS/BURS: _________
________________________________________ Amount : ______________________
Signature over Printed Name of Chief
Accountant/Head of Accounting Division/Unit
DEPEDBATS-PTY-F-004/R0/05-30-2018
Republic of the Philippines
For BIR BCS/ Department of Finance
Use Only Item: Bureau of Internal Revenue
BIR Form No.
Certificate of Creditable Tax
2307
January 2018 (ENCS)
Withheld at Source 2307 01/18ENCS
Fill in all applicable spaces. Mark all appropriate boxes with an "X".
1 For the Period From 1 0 0 1 2 0 2 1 (MM/DD/YYYY) To 1 2 3 1 2 0 2 1 (MM/DD/YYYY)
Part I – Payee Information
2 Taxpayer Identification Number (TIN) 2 5 4 - 2 6 6- 3 9 7- 0 0 0
3 Payee’s Name (Last Name, First Name, Middle Name for Individual OR Registered Name for Non-Individual)
MYH EXPRESS PRINT CENTER
4 Registered Address 4A ZIP Code
B3 L38 Dao Drive Camilla Seville Habay II, Bacoor Cavite 4 1 0 2
5 Foreign Address, if applicable
Part II – Payor Information
6 Taxpayer Identification Number (TIN) 4 4 1 - 9 2 6- 5 1 1- 0 8 4 6
7 Payor’s Name (Last Name, First Name, Middle Name for Individual OR Registered Name for Non-Individual)
DepEd - Division of Batangas Province
8 Registered Address 8A ZIP Code
Batangas Provincial Sports Complex, Bolbok, Batangas City 4 2 0 0
Part III – Details of Monthly Income Payments and Taxes Withheld
AMOUNT OF INCOME PAYMENTS
Income Payments Subject to Expanded Tax Withheld for the
ATC 1st Month of the 2nd Month of the 3rd Month of the
Withholding Tax Total Quarter
Quarter Quarter Quarter
Income payments made by the government
WC157 6,040.00 6,040.00 120.80
and government-owned and controlled
corporations (GOCCs) to its local/resident
suppliers of services other than those covered
by other rates of withholding tax
Income payments made by the government WC640
and government-owned and controlled
corporations (GOCCs) to its local/resident
suppliers of goods other than those covered by
other rates of withholding tax
Total 6,040.00 6,040.00 120.80
Money Payments Subject to Withholding of
Business Tax (Government & Private)
Persons Exempt from VAT under Sec. 109BB WB080 6,040.00 6,040.00 60.40
(creditable)-Government Withholding Agent
FWVAT on payments for purchase of Services
FWVAT on payments for purchase of Goods
Total 6,040.00 6,040.00 60.40
We declare under the penalties of perjury that this certificate has been made in good faith, verified by us, and to the best of our knowledge and belief, is true and correct,
pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Further, we give our consent to the
processing of our information as contemplated under the *Data Privacy Act of 2012 (R.A. No. 10173) for legitimate and lawful purposes.
REYNALYN S. MENDOZA
Principal I/ 246-981-623
Signature over Printed Name of Payor/Payor’s Authorized Representative/Tax Agent
(Indicate Title/Designation and TIN)
Tax Agent Accreditation No./ Date of Issue Date of Expiry
Attorney’s Roll No. (if applicable) (MM/DD/YYYY) (MM/DD/YYYY)
CONFORME:
HEIDELBELT C. CACACTIN
Supplier / 254-268-397-000
Signature over Printed Name of Payee/Payee’s Authorized Representative/Tax Agent
(Indicate Title/Designation and TIN)
Tax Agent Accreditation No./ Date of Issue Date of Expiry
Attorney’s Roll No. (if applicable) (MM/DD/YYYY) (MM/DD/YYYY)
*NOTE: The BIR Data Privacy is in the BIR website (www.bir.gov.ph)
