Province of Ilocos Norte

Municipality of Piddig
Republic of the Philippines

OBLIGATION REQUEST MOOE 2019-

Payee BUREAU OF THE TREASURY

Office LAOAG CITY

Address LAOAG CITY

Responsibility
Center Particulars P.P.A. Account Code Amount

To payment of Fidelity Bond of Municipal

officials and employees of this
10,500.00
Municipality as per supporting papers
hereto attached…

A & other B Certified

Charges to appropriation/allotment necessary, lawful and Certified as to availability of

under my direct supervision Appropriation/Allotment

Supporting documents valid, proper and legal

Signature Signature

Printed Name OFELIA J. VENTURA Printed Name EMMA M. MARTIN

Position Municipal Treasurer Position Municipal Budget Officer

Date Date
 PURCHASE REQUEST
Municipality of Piddig

Date:
Department MUNICIPAL TREASURER'S OFFICE Date:
Section Piddig, Ilocos Norte Date:

Quantity Unit of Issue Item Description Stock Estimated Estimated

No. Unit Cost Cost
255 ltrs. Desoline 33.00 8,415.00
7 ltrs. oil 150.00 1,050.00

9,465.00
Purpose:
for the service vehicle SFX-909, used this Municipality Gasoline for the period of August
1-31, 2016
August 1-31,2016

Source of Fund:
Requested by: Approved By:
Signature:
Printed Name: MONICA C. SALISA GEORGINA S.GUILLEN
Designation: Municipal Treasurer Municipal Mayor
Cash Availability APPROPRIATIONS AVAILABLE:

MONICA C. SALISA EMMA M. MARTIN

Municipal Treasurer Budget Officer
 Province of Ilocos Norte
Municipality of Piddig
Province of Ilocos Norte
No.:
DISBURSEMENT VOUCHER

Mode of
Check Cash Others
Payment

TIN/Employee No. Obligation Request No.

PAYEE BUREAU OF THE TREASURY

Responsibility Center
Address LAOAG CITY Office/Unit/Project Code

EXPLANATION AMOUNT

To payment of Fidelity Bond of Municipal officials and employees of this Municipality as per supporting
10,500.00
papers hereto attached…

TOTAL 10,500.00
A Certified: B Certified
Allotment obligated for the purpose as indicated above Funds Available
Supporting documents complete

Signature Signature

Date Date
Printed Name VICTOR P. PASCUAL Printed Name OFELIA J. VENTURA
Municipal Accountant Municipal Treasurer
Position Position
Head, Accounting Unit/Authorized Representative Tresurer/Authorized Representative

C Approved for Payment: D Received Payment

Check No. Bank Name Date

Signature

Signature
Printed Name EDUARDO EDDIE G. GUILLEN Printed Name BUREAU OF THE TREASURY
Municipal Mayor OR/Other Documents JEV No. Date
Position

JEV No. :
JOURNAL ENTRY VOUCHER
Date:

Collection Check Disbursement Cash Disbursement Others

ACCOUNTING ENTRIES
Responsibility Account Amount
Accounts and Explanation PR
Center Code Debit Credit

TOTAL

Prepared by: Approved by:

MAILEEN C. TAGACA VICTOR P.PASCUAL
Admin Officer II Municipal Accountant
PETTY CASH VOUCHER No. _________________

Payee: MONICA C. SALISA

Address: Piddig, Ilocos Norte

Responsibility Center

1. To be filled up upon request Amount 2. To be fill up upon liquidation

To reimbursement of expenses incurred for the

purchased of Diesoline used for on official 2,002.83
business.

TOTAL 2,002.83

A. Requested by: C.

MONICA C.SALISA
Name Of Requestor

Received Refund
Approved by: X Reimbursement

GENEROSO L. AQUINO, JR. MONICA C. SALISA

Acting Municipal Mayor Disbursesing Officer

B. Paid by: D.

Liquidation Submitted
MONICA C. SALISA Reimbursement Received by:
Disbursing Officer

CASH received by:

MONICA C. SALISA MONICA C. SALISA

Signature over Printed Name of the Peyee Signature over Printed Name of the Peyee

Date ____________________
P
 Province of Ilocos Norte
Municipality of Piddig
Republic of the Philippines

OBLIGATION REQUEST 2017-04-

Payee MONICA C. SALISA

Office Office of the Municipal Treasurer
Address Piddig, Ilocos Norte
Responsibility
Particulars P.P.A. Account Code Amount
Center

To reimbursement of expenses incurred

for the purchased of Diesoline used for 2,002.83
on official business.

A Certified
& other B

Charges to appropriation/allotment necessary, lawful and Certified as to availability of

under my direct supervision Appropriation/Allotment

Supporting documents valid, proper and legal

Signature Signature

MONICA C.SALISA EMMA M. MARTIN

Printed Name Printed Name

Municipal Treasurer Municipal Budget Officer

Position Position

Date 4/18/2017 Date 4/18/2017

5 copies