Form 4: Annex E
(AGENCY LETTERHEAD)
LIST OF BONDED ACCOUNTABLE PUBLIC OFFICER/S
TYPE OF APPLICATION
PREVIOUS YEAR'S DATA
AMOUNT PREFERRED
(Check "ü" the DESIGNATION (e.g. EFFECTIVITY DATE BOND REMARKS (WITH/WITHOUT
NAME OF PUBLIC OFFICER appropriate column) Disbursing/ RISK NO. COVERAGE PENDING ADMINISTRATIVE AND
From To
Collecting/Signing Officer) (1, 2, or 3 CRIMINAL CASE)
ACCOUNTABILITY BOND PREMIUM YEARS)
NEW RENEWAL ( For Renewal)
DWIGHT R'GYME C. BADUA / SK CHAIRPERSON 71,607.70 60000.00 900 1 No Pending Case
BRANDON P. BARAYUGA / SK TREASURER 71,607.70 60000.00 900 1 No Pending Case
Prepared by: Certified and Approved by:
BRANDON P. BARAYUGA ALFREDO P. VALDEZ JR M.D.
SK TREASURER MUNICIPAL MAYOR