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Annex 12

Disbursement Voucher DV No:


Barangay: City/Municipality: GEN. TRIAS Date:
Payee: D3L CONSUMER GOODS Province: CAVITE Fund: SK FUND
TRADING
Address: GEN. TRIAS, CAVITE TIN:
Amount
Particulars

TO PAYMENT THE AMOUNT PAID FOR THE SOUVENIR SHIRT


PURCHASED FOR THE PROJECT AGILA IN THE AMOUNT OF 0.00
……………… - 0.00

3% = 0.00
1% = .00
0.00

0.00

A. Certified as to availability B. Certified as to availability C. Certified as to necessity,


of the budget or funds received of cash, and completeness and validity, propriety, and legality
for specific purpose propriety of supporting of claim; and approved for
documents payment:

(Signature Over Printed Name) (Signature Over Printed Name) (Signature Over Printed Name)
SK Budget Monitoring Officer SK Treasurer SK Chairperson

Date: Date: Date:

E. Received Payment: Check No: ____________________ Date: ___________


Bank Name: ____LBP – Cavite_____
OR No: ____________________
D3L CONSUMER GOODS TRADING
(Signature Over Printed Name)
Date:_________________________
D. Accounting Entries
Account Account Code Debit Credit

Prepared by:
Barangay Bookkeeper
___________________________________ ________ _
Date
Approved by:
__________________________________ ______ __
City/Municipal Accountant Date

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