Republic of the Philippines

MUNICIPALITY OF BUSUANGA
Busuanga, Palawan
DISBURSEMENT VOUCHER No.
Mode of
Payment Check Cash Others
NATIONAL TREASURER OF THE PHILIPPINES TIN/Employee No.
Obligation Request No.
Payee
Responsibility Center
Address Busuanga, Palawan Office Unit/Project Code:

EXPLANATION AMOUNT

Refund of unexpended balance of Performance Challenge Fund (PCF)

as of December 30, 2012. 14,055.94

Total 14,055.94
A. Certified B. Certified
Allotment obligated for the purpose as indicated above Funds Available

Supporting documents complete

Signature Signatur
Printed DATE Printed DATE
EUNICE G. TIBUDAN JEROME M. PADRONES
Name Name
Municipal Accountant Municipal Treasurer
Position Position
Head, Accounting Unit/Authorized Representati Treasurer/Authorized Representative
C. Approved for Payment D. Received Payment
Signature Check No Date

Printed DATE Signatur

Name SAMUEL A. DE JESUS, SR.
Printed NATIONAL TREASURER OF THE PHILIPPINES
Name
Municipal Mayor
Position OR/Other DocumentsJEV No. Date
Agency Head/Authorized Representative
 Republic of the Philippines
MUNICIPALITY OF BUSUANGA
Busuanga, Palawan
DISBURSEMENT VOUCHER No.
Mode of
Payment Check Cash Others
Payee Municipal Treasurer of Busuanga TIN/Employee No. Obligation Request No.

Responsibility Center
Address Busuanga, Palawan Office Unit/Project Code:

EXPLANATION AMOUNT

To transfer Local Disaster Risk Reduction and Management Fund

(LDRRMF)unexpended/unobligated balances from General Fund to
Trust Fund Account. 3,802,597.29

Total 3,802,597.29
A. Certified B. Certified
Allotment obligated for the purpose as indicated above Funds Available

Supporting documents complete

Signature Signature
Printed EUNICE G. TIBUDAN DATE Printed JEROME M. PADRONES
Name Name
Municipal Accountant Municipal Treasurer
Position Position
Head, Accounting Unit/Authorized Representa Treasurer/Authorized Representative
C. Approved for Payment D. Received Payment
Signature Check No.

Printed DATE Signature

Name SAMUEL A. DE JESUS, SR.
Printed Municipal Treasurer of Busuanga
Name
Municipal Mayor
Position
 Municipal Mayor
Position OR/Other DocumentsJEV No.
Agency Head/Authorized Representative
Obligation Request No.

y Center

AMOUNT

3,802,597.29

3,802,597.29

DATE

reasurer
rized Representative

Date

asurer of Busuanga
Date
 AnnexA

Republic of the Philippines

MUNICIPALITY OF BUSUANGA
Busuanga, Palawan
OBLIGATION REQUEST No.
Payee EUNICE G. TIBUDAN
Office OFFICE OF THE MUNICIPAL ACCOUNTANT
Address SALVACION, BUSUANGA, PALAWAN
Responsibility Particulars F.P.P. Account Amount
Center Code

Reimbursement for travelling expenses to attend 36th

GACPA National Convention on May 21-24, 2014 in Puerto
Princesa City and to submit reports to COA. 2,700.00

TOTAL 2,700.00
Certified Certified
Charges to appropriation/Allotment necessary, lawful Existence of available appropriation
and under my direct supervixion

Supporting documents valid, proper and legal

Signature Signature
Printe
Printed
EUNICE G. TIBUDAN d AIDA O. DOMINGUEZ
Name
Name
Position Municipal Accountant Name Municipal Budget Officer
Head, Requesting Office/Authorized Head,Budget Unit/Authorized Representative
Date Date