ANNEX D:
DATA CHANGE REQUEST FORM
                                                                                              REPUBLIKA NG PILIPINAS
                                                                                            KAGAWARAN NG PANANALAPI
                                                                                        KAWANIHAN NG INGATANG-YAMAN
                                                                                             (BUREAU OF THE TREASURY)
                                                          Funding the Republic
                                                                                  Data Change Request Form (DCR)
DATE OF REQUEST:                               BANK:                                    REQUESTING BANK/AGENCY:                                 BANK/AGENCY ADDRESS:
December 2,2024                                Landbank-Butuan                                       DAR Regional Office                                    J.C. Aquino Montilla Boulevard Butuan City
APPLICATION SYSTEM:                            NATIONAL GOVERNMENT COLLECTION AND DISBURSEMENT SYSTEM (NGCDS)
                  REASON/S OF ADJUSTMENT:
                  Returned checks
                  Over/Under//Double posted collections
                  Reclassification of type of funding source due to incorrect clearing account used
                  Reclassification of NCO Code and Organization Code of the Agency to be credited
  DETAILS OF DATA CHANGE:
                  NGCDS (per Actual Remittance : OnColl Payment Slip, LDDAP, CM etc)                                                                      SHOULD BE
                                  Agency    UACS Org Code                                Funding                                     Agency    UACS Org Code                             Funding
                   Clearing                                 NCO                  Fund                                  Clearing                                      NCO       Fund
   Deposit Date                  Name to be of Agency to be                               Source          Amount                    Name to be of Agency to be                            Source         Amount
                   Account                                  Code                 Type                                  Account                                       Code      Type
                                  credited      credited                                  Code                                       credited      credited                               Code
                              National
     6/29/2022     3402244835 Treasury Dar                                                                174,575.00 3402-2844-46   DAR XIII           40010300016 CE0180                                174,575.00
                              Caraga
  Reference:
  Fund Type                                                        Funding Source Code
  General Fund                                                     01-101101
  Special Account in the General Fund (SAGF)                       (refer to Annex A of TC 2-2022)
  Inter-Agency Transferred Fund (IATF)                             07-308601
  Other-than IATF                                                  07-308602
                  Endorsed by:                                                                                                      Approved by:
                                EMELYN C. CAPITANIA/CASHIER II                                                                      ATTY.MERLITA S. CAPINPUYAN/Regional Director
                                   Name of the Preparer                                                                                Authorized Signatory
                                   Position/Designation                                                                                 Position/Designation
                                                                                                     Instructions:
This portion is for BTr-National Cash Accounting Division (NCAD)
                                                                                                     This form shall be accomplished:
          DATE RECEIVED:                                                                             1. To correct/reclassify the type of funding source due to incorrect clearing account used
                                                                                                     2. To correct/reclassify the NCO Code and Organization code of the Agency to be credited.
                  If reclassified and recognized in the BTr NG Books:                                Required fields must be properly filled up on the SHOULD BE portion based on the details that are subject
                  JEV Number:                                                                        for correction or data change:
                  JEV Date:                                                                          1. if for Clearing Account: Clearing Account / Fund Type / Funding Source Code (8-digit numeric)*
                                                                                                     2. if for Agency: Agency Name to be Credited / UACS Org Code of Agency to be credited (12-digit
                  If not yet reclassified in the BTr NG Books:                                       numeric)
                  Option in NGCDS module to:
                                                                                                     3. if for NCO Code: NCO Code (6-digit alphanumeric)
                                                                                                     4. if Amount: Amount / other columns that need to be corrected
                        Add                                                                          Note: This form must be accompanied by supporting attachments from the concerned AGDBs &
                         Edit                                                                        NGAs in conformity with the Specific Guidelines, item III Adjustments of the Treasury Circular No.
                        Del                                                                          02-2022 dated May 31, 2022.
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