Appendix 28

Republic of the Philippines

Province of Zamboanga de Sur
Municipality of Guipos
CERTIFICATE ON APPRPRIATIONS, FUNDS AND OBLIGATION
OF ALLOTMENT

Obligation No.:

Request Approved Amount:

Payee Certification:

Allotment Expense I hereby certify as to the existence of

Function Amount
Class Code appropriations for the expenditures in the
amount specified herein:

Municipal Budget Officer Date

Certification:
Total amount requested:
Amount in Words: I hereby certify as to the availability of funds
for the expedatures in the amount specified
herein:

Requesting Officials:
Municipal Treasurer Date

_______________________ _____________
Name and Signature Date Certification:

I hereby certify that the allotment are available

for obligation in the amount specified herein:

Municipal Accountant Date

Subsidiary Ledger

Obligation Increase
Date Particulars/Reference Liquidations Balance
(Decrease)
 Appendix 29

FUND UTILIZATION REQUEST AND STATUS FURS No. : ______________

Municipality of Guipos Date : __________________
LGU Fund :__________________

Payee

Office

Address

Project/Purpose Particulars Account Code Amount

Total
A. Certified: Charges to special trust account necessary, B. Certified: Funds available and utilized for
lawful and under my direct supervision; and supporting the purpose/adjustment necessary as
documents valid, proper and legal indicated above

Signature : __________________________________ Signature : ____________________________

Printed Name: __________________________________ Printed Name: ____________________________

Position : __________________________________ Position : ____________________________

Head, Requesting Office/Authorized Head, Accounting Division/Unit/
Representative Authorized Representative
Date : _______________________________ Date : ____________________________

C. STATUS OF UTILIZATION
Reference Amount
Balance
FURS/JEV/RCI/ Utilization Payable Payment Due and
Date Particulars Not Yet Due Demandable
RADAI No.
(a) (b) (c) (a-b) (b-c)
 Appendix 30

JOURNAL VOUCHER JV No.:

LGU : Municipality of Guipos Date :

Fund : _________________________________________

ACCOUNTING ENTRIES
FPP Amount
Accounts and Explanation Account Code P
Debit Credit

TOTAL
Prepared by: Certified Correct:

_______________________________ __________________________________
Accounting Personnel Head, Accounting Division/Unit
 Fund:
DISBURSEMENT VOUCHER
Municipality of Guipos DV No.:
LGU Date:

Payee: ID No./TIN:
ARJYL P. NAGAL CAFOA No.:
Responsibility Center:
Address: POBLACION, GUIPOS, ZAMBOANGA DEL SUR

Particulars Amount
Reimbursement of per diem and allowances during and Official Travel at Roxan
Hotel, Pagadian City to attend Monthly Conference, dated March 19, 2021 as per
suppoting papers hereto attached… 1900.00

Amount Due 1,900.00

A Certified: B Certified: C Certified:
Expenses/Cash Advances necessary, Completeness and propriety of supporting Funds available for the purpose.
valid, proper, lawful and incurred documents/previous cash advance
under my direct supervision. liquidated/existence of funds held in
trust.

ALICIA R. BUYSER RANULFO T. SALIOT, MPA Engr. MELVIN O. VILLARTA

OIC Budget Officer OIC - Municipal Accountant Municipal Treasurer

D Approved For Payment: P______ E Received Payment:

D Payment:
D Check No. _______________
Bank Name: _____________
Engr. VICENTE P. CAJETA Date: ___________________ ARJYL P. NAGAL
Municipal Mayor Signature Over Printed Name/Position
Date________

F Accounting Entries
Particulars Account Code Debit Credit

Prepared by: Certified Correct:

LUCENIA A. FORTE RANULFO T. SALIOT, MPA
Administrative Aide VI OIC - Municipal Accountant
 Appendix 31

Fund:
DISBURSEMENT VOUCHER
Municipality of Guipos DV No.:
LGU Date:

Payee: ID No./TIN:
MELVINSON LOUI P. SARCAUGA CAFOA No.:
Responsibility Center:
Address: BALONGATING, GUIPOS, ZAMBOANGA DEL SUR

Particulars Amount
Reimbursement of per diem and allowances during and Official Travel at Panoramic
Paradise Resort, Ramon Magsaysay, Zamboanga del Sur to attend 1st Quarter CPO
Mobile Conference, dated March 19, 2021, as per supporting papers hereto attached.. 1500.00

Amount Due 1,500.00

A Certified: B Certified: C Certified:
Expenses/Cash Advances necessary, Completeness and propriety of supporting Funds available for the purpose.
valid, proper, lawful and incurred documents/previous cash advance
under my direct supervision. liquidated/existence of funds held in
trust.

Engr. VICENTE P. CAJETA RANULFO T. SALIOT, MPA Engr. MELVIN O. VILLARTA

Municipal Mayor OIC - Municipal Accountant Municipal Treasurer

D Approved For Payment: P______ E Received Payment:

D Payment:
D Check No. _______________
Bank Name: _____________
Engr. VICENTE P. CAJETA Date: ___________________ MELVINSON LOUI P. SARCAUGA
Municipal Mayor Signature Over Printed Name/Position
Date________

F Accounting Entries
Particulars Account Code Debit Credit

Prepared by: Certified Correct:

LUCENIA A. FORTE RANULFO T. SALIOT, MPA
Administrative Aide VI OIC - Municipal Accountant
 Appendix 35

LIQUIDATION REPORT Serial No.: ___________

Period Covered ________________ Date: _______________

LGU : ________________________________________ Function/Program/Project

Fund : _______________________________________ _______________________

PARTICULARS Amount

TOTAL AMOUNT SPENT

AMOUNT OF CASH ADVANCE PER DV NO. ___________ DTD.
_____________
AMOUNT REFUNDED PER OR NO.__________ DTD. _________

AMOUNT TO BE REIMBURSED
A Certified: Correctness of the B Certified: Purpose of travel/cash C Certified: Supporting documents
above data advance duly accomplished complete and proper

Signature over Printed Name Signature over Printed Name Signature over Printed Name
Claimant Immediate Supervisor Head, Accounting Division Unit
Date:_______________ Date:__________________ Date:__________________
 Appendix 46

ITINERARY OF TRAVEL

LGU : __ GUIPOS, ZAMBOANGA DEL SUR

Fund : ________________________________ No.: _______________
Name : MELVINSON LOUI P. SARCAUGA Date of Travel 19-Mar-21
Position HRMO IV Purpose of Travel :(SEE ATTACHED COMMUNICATION)
Official Station : _______________________
Places to be visited TIME Means of Transpor- Per
Date Others Total Amount
(Destination) Departure Arrival Transportation tation Diem
3/19/2021 Pagadian City to Ramon Magsaysay 6:00am 7:00am Van for Hire 100.00 300.00 400.00
Ramon Magsaysay to Pagadian City 5:00pm 6:00pm Van for Hire 100.00 100.00
Registration Fee 1,000.00 1,000.00

TOTAL 200.00 300.00 1,000.00 1,500.00

Prepared by :

MELVINSON LOUI P. SARCAUGA

I certify that : (1) I have reviewed the foregoing HRMO IV
itinerary, (2) the travel is necessary to the service,
(3) the period covered is reasonable and (4) the Approved by:
expenses claimed are proper.

ENGR. VICENTE P. CAJETA ENGR. VICENTE P. CAJETA

Municipal Mayor Municipal Mayor
ION)
 Appendix 47

PURCHASE REQUEST

LGU: GUIPOS, ZAMBOANGA DEL SUR Fund: ANNUAL GEN. FUND 2021
Department : LEGISLATIVE PR No.: ______________ Date: March 23, 2021
Section:___________________ FPP : ___________________
Unit Total
Item No. Unit Item Description Quantity
Cost Cost
1 reams Bondpaper (Long Size) 5
2 Unit Printer 1

Purpose: Supplies and equipment used by the office__________________________

_______________________________________________________________
_______________________________________________________________

Requested by: Cash Availability: Approved by:

______________________ _____________________ ________________________
Signature :
___ _ ___
Printed Name : HON. JUNEVELL S. ORAIZ - LAMIING ENGR. MELVIN O. VILLARTA ENGR. VICENTE P. CAJETA

Designation : Municipal Vice Mayor Municipal Treasurer Municipal Mayor

 PURCHASE ORDER
Municipality of Guipos
LGU

Supplier : _____________________________________________ P.O. No. : ____________________________

Address : _____________________________________________ Date : _______________________________
___________________________________________________ Mode of Procurement : _________________
TIN : ________________________________________________ PR No./s
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:

Place of Delivery : ___________________________________ Delivery Term : ________________________

Date of Delivery : ____________________________________ Payment Term : ________________________

Stock/
Unit Description Quantity Unit Cost
Property No.

(Total Amount in Words)

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,

_______________________________ ________________________________
Signature over Printed Name of Supplier
Signature over Printed Name of Authorized Official

___________________________ _____________________________
Date Designation

(In case of Negotiated Purchase pursuant to Section 369 (a) of RA 7160, this portion must be accomplished.)

Approved per Sanggunian Resolution No.: _____________________________________________________

Certified Correct:
_____________________________ __________
Secretary to the Sanggunian Date
 Appendix 49

______________________
______________________
ment : _________________

ntained herein:

________________________
________________________

Amount

tenth (1/10) of one percent for

_______________________

nted Name of Authorized Official

_____________________
Designation

must be accomplished.)

_______________
 Appendix 50

ACCEPTANCE AND INSPECTION REPORT

LGU : ______________________________ Fund : ___________

Supplier : ____________________________________ AIR No. : _______________

PO No./Date : ________________________________ Date : _________________
Requisitioning Office/Dept. : ______________________ Invoice No. : ____________
Date : _________________

Stock/ Property
Description Unit Quantity
No.

ACCEPTANCE INSPECTION

Date Received : ________________________ Date Inspected : _____________________

Complete Inspected, verified and found in order as

to quantity and specifications
Partial (pls. specify)

____________________________________________ ___________________________________
Supply and/or Property Custodian Inspection Officer/Inspection Committee
 Appendix 33

No. : __________________
PETTY CASH VOUCHER
LGU : _________________________________ Date : _________________
Fund : _____________________________
FPP:
Payee/Office : ____________________________ ______________________
Address : ________________________________

I. To be filled out upon request II. To be filled out upon liquidation

Particulars Amount
Total Amount Granted ______________

Total Amount Paid per

OR/Invoice No. _______ ______________

Amount Refunded/
(Reimbursed)

Requested by:
Received Refund
__________________________
Signature over Printed Name Reimbursement Paid
Requestor

Approved by:

__________________________ __________________________
Signature over Printed Name Signature over Printed Name
Immediate Supervisor Petty Cash Custodian

Paid by:
Liquidation Submitted
__________________________
Signature over Printed Name Reimbursement Received by:
Petty Cash Custodian
Cash Received by:
__________________________ __________________________
Signature over Printed Name Signature over Printed Name
Payee Payee
Date: _______________ Date: _______________
eceived by:
 Appendix 32

PAYROLL
For the period MARCH 1-31, 2021

LGU : ___ MUNICIPALITY OF GUIPOS Payroll No. : 01-2021

Fund : __PS 2021 LEGISLATIVE DEPARTMENT Sheet 1 of 4 Sheets
We acknowledge receipt of cash shown opposite our name as full compensation for services rendered for the period covered.

COMPENSATIONS DEDUCTIONS
Serial Name Position Employee Net Amount Signature of Recipient
No. No. Salaries Gross Due
and Wages Amount Total
- JO Earned Deductions

1 ELIZABETH CLOMA Office Aide 3,960.00 3,960.00 - 3,960.00

2 LORETO VERGEL ORDONEZ Office Aide 3,960.00 3,960.00 - 3,960.00
3 ROBERTO ALEJAY Office Aide 3,960.00 3,960.00 - 3,960.00
4 BERNIE TEJADA Office Aide 3,960.00 3,960.00 - 3,960.00
5 FELICIANO REQUIRON Office Aide 3,960.00 3,960.00 - 3,960.00
TOTAL 19,800.00 19,800.00 - 19,800.00
A CERTIFIED: Services duly rendered as stated. B CERTIFIED: Supporting documents complete and proper. C CERTIFIED: Cash available for the purpose.

JUNEVELL S. ORAIZ-LAMIING RANULFO T. SALIOT, MPA ENGR. MELVIN O. VILLARTA

Signature over Printed Name Date Signature over Printed Name Date Signature over Printed Name Date
Authorized Official Head of Accounting Division/Unit
Head of Treasury Division/Unit

D APPROVED FOR PAYMENT: P_________________ E CERTIFIED: Each employee whose name appears F
on the payroll has been paid the amount as
indicated opposite his/her name
CAFOA No. : _____________
Date : ___________________
JUNEVELL S. ORAIZ-LAMIING ENGR. MELVIN O. VILLARTA
Signature over Printed Name/Position Date Signature over Printed Name Date
Local Chief Legislative Disbursing Officer
G ACCOUNTING ENTRIES

Particulars Account Code Debit Credit Particulars Account Code Debit Credit

Prepared by: Certified Correct:

LUCENIA A. FORTE RANULFO T. SALIOT, MPA
Administrative Assistant IV Head, Accounting Department/Unit
 Appendix 32

PAYROLL
For the period MARCH 1-31, 2021

LGU : _ MUNICIPALITY OF GUIPOS Payroll No. : 01-2021

Fund : PS 2021 LEGISLATIVE DEPARTMENT Sheet 2 of 4 Sheets
We acknowledge receipt of cash shown opposite our name as full compensation for services rendered for the period covered.

COMPENSATIONS DEDUCTIONS
Serial Employee Salaries Gross Net Amount
Name Position Total Signature of Recipient
No. No. and Wages Amount Due
Deductions
- Regular Earned
1 MENESES MAGUINSALOG Office Aide 3,960.00 3,960.00 - 3,960.00
2 ALVIN LAMOSA JR. Office Aide 3,960.00 3,960.00 - 3,960.00
3 EDMOND TABACULDE Office Aide 3,960.00 3,960.00 - 3,960.00
4 REWEL LUMINOG Office Aide 3,960.00 3,960.00 - 3,960.00
5 ALBERT BASCON Office Aide 3,960.00 3,960.00 - 3,960.00
TOTAL 19,800.00 19,800.00 - 19,800.00
A CERTIFIED: Services duly rendered as stated. B CERTIFIED: Supporting documents complete and proper. C CERTIFIED: Cash available for the purpose.

JUNEVELL S. ORAIZ-LAMIING RANULFO T. SALIOT, MPA ENGR. MELVIN O. VILLARTA

Signature over Printed Name Date Signature over Printed Name Date Signature over Printed Name Date
Authorized Official Head of Accounting Division/Unit Head of Treasury Division/Unit

D APPROVED FOR PAYMENT: P_________________ E CERTIFIED: Each employee whose name appears on the payroll has F
been paid the amount as indicated opposite his/her name

CAFOA No. : _____________

Date : ___________________
JUNEVELL S. ORAIZ-LAMIING ENGR. MELVIN O. VILLARTA
Signature over Printed Name/Position Date Signature over Printed Name Date
Local Chief Legislative Disbursing Officer
G ACCOUNTING ENTRIES
Particulars Account Code Debit Credit Particulars Account Code Debit Credit

Prepared by: Certified Correct:

LUCENIA A. FORTE RANULFO T. SALIOT, MPA
Administrative Assistant IV Head, Accounting Department/Unit
 Appendix 32

PAYROLL
For the period MARCH 1-31, 2021

LGU : _ MUNICIPALITY OF GUIPOS Payroll No. : 01-2021

Fund : PS 2021 LEGISLATIVE DEPARTMENT Sheet 3 of 4 Sheets
We acknowledge receipt of cash shown opposite our name as full compensation for services rendered for the period covered.

COMPENSATIONS DEDUCTIONS
Serial Employee Salaries Gross Net Amount
Name Position Total Signature of Recipient
No. No. and Wages Amount Due
Deductions
- Regular Earned
1 PEPE TAGALOGON Office Aide 3,960.00 3,960.00 - 3,960.00
2 JESSILA MANLIQUES Office Aide 3,960.00 3,960.00 - 3,960.00
3 JUANA PELLARCA Office Aide 3,960.00 3,960.00 - 3,960.00
4 JONALYN ALJAS Office Aide 3,960.00 3,960.00 - 3,960.00
5 GERALD TAGALOGUIN Office Aide 3,960.00 3,960.00 - 3,960.00
TOTAL 19,800.00 19,800.00 - 19,800.00
A CERTIFIED: Services duly rendered as stated. B CERTIFIED: Supporting documents complete and proper. C CERTIFIED: Cash available for the purpose.

JUNEVELL S. ORAIZ-LAMIING RANULFO T. SALIOT, MPA ENGR. MELVIN O. VILLARTA

Signature over Printed Name Date Signature over Printed Name Date Signature over Printed Name Date
Authorized Official Head of Accounting Division/Unit Head of Treasury Division/Unit

D APPROVED FOR PAYMENT: P_________________ E CERTIFIED: Each employee whose name appears on the payroll has F
been paid the amount as indicated opposite his/her name
CAFOA No. : _____________
Date : ___________________
JUNEVELL S. ORAIZ-LAMIING ENGR. MELVIN O. VILLARTA
Signature over Printed Name/Position Date Signature over Printed Name Date
Local Chief Legislative Disbursing Officer
G ACCOUNTING ENTRIES
Particulars Account Code Debit Credit Particulars Account Code Debit Credit

Prepared by: Certified Correct:

LUCENIA A. FORTE RANULFO T. SALIOT, MPA
Administrative Assistant IV Head, Accounting Department/Unit
 PAYROLL
For the period MARCH 1-31, 2021

LGU : _ MUNICIPALITY OF GUIPOS Payroll No. : 01-2021

Fund : PS 2021 LEGISLATIVE DEPARTMENT Sheet 4 of 4 Sheets
We acknowledge receipt of cash shown opposite our name as full compensation for services rendered for the period covered.

COMPENSATIONS DEDUCTIONS
Serial Employee Salaries Gross Net Amount
Name Position Total Signature of Recipient
No. No. and Wages Amount Due
Deductions
- Regular Earned
1 ROMABEL GALINADA Office Aide 3,960.00 3,960.00 - 3,960.00
2 JEZYL CANDIA Office Aide 3,960.00 3,960.00 - 3,960.00

TOTAL 7,920.00 7,920.00 - 7,920.00

A CERTIFIED: Services duly rendered as stated. B CERTIFIED: Supporting documents complete and proper. C CERTIFIED: Cash available for the purpose.

JUNEVELL S. ORAIZ-LAMIING RANULFO T. SALIOT, MPA ENGR. MELVIN O. VILLARTA

Signature over Printed Name Date Signature over Printed Name Date Signature over Printed Name Date
Head of Accounting Division/Unit Head of Treasury Division/Unit
Authorized Official

D APPROVED FOR PAYMENT: P_________________ E CERTIFIED: Each employee whose name appears on the payroll has F
been paid the amount as indicated opposite his/her name
CAFOA No. : _____________
Date : ___________________
JUNEVELL S. ORAIZ-LAMIING ENGR. MELVIN O. VILLARTA
Signature over Printed Name/Position Date Signature over Printed Name Date
Local Chief Legislative Disbursing Officer
G ACCOUNTING ENTRIES
Particulars Account Code Debit Credit Particulars Account Code Debit Credit

Prepared by: Certified Correct:

LUCENIA A. FORTE RANULFO T. SALIOT, MPA
Administrative Assistant IV Head, Accounting Department/Unit