OBLIGATION REQUEST AND STATUS Serial No.
:
Date :
DEPED-SCHOOLS DIVISION OF TARLAC PROVINCE
Entity Name
Fund Cluster :
Payee MELQUIADEZ S. MANALO JR.
Office Victoria East Central ES
Address Victoria , Tarlac
UACS Object
Responsibility Center Particulars MFO/PAP Amount
Code
To payment of meals expense incurred during NLC
and EOSY activities….
5010403001 65,745.45
-
-
-
Total 65,745.45
A. B. Certified: Allotment available and obligated
Certified: Charges to appropriation/alloment are
necessary, lawful and under my direct supervision;and for the purpose/adjustment necessary as
supporting documents valid, proper and legal indicated above
Signature : Signature :
Printed Name: JOVITA G. DIZON Printed Name: JEROME C. VALETE, CPA
Position : ADMINISTRATIVE OFICER V Position : BUDGET OFFICER III
Head, Requesting Office/Authorized Representative Head, Budget Division/Unit/Authorized
Representative
Date : ___________________________________ Date : ____________________________
C. STATUS OF OBLIGATION
Reference Amount
Balance
ORS/JEV/Check/ Obligation Payable Payment Due and
Date Particulars Not Yet Due
ADA/TRA No. Demandable
(a) (b) (c) (a-b) (b-c)
Monetization of Leave 65,745.45
DEPED-SCHOOLS DIVISION OF TARLAC PROVINCE Fund Cluster :
Entity Name
Date :
DISBURSEMENT VOUCHER DV No. :
Mode of MDS Check Commercial Check ADA Others (Please specify)
Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee MELQUIADEZ S. MANALO, JR.
5417641
Address Victoria East Central ES, Victoria, Tarlac
Responsibility
Particulars MFO/PAP Amount
Center
To payment of: Monetization of Leave Credits 2023 of Mr.
Guillermo G. Gelacio, in the amount of: 5010403001 65,745.45
Amount Due - 65,745.45
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
JOVITA G. DIZON
Administrative Officer V
B. Accounting Entry:
Account Title UACS Code Debit Credit
Terminal Leave Benefits 5010403001 65,745.45
Cash-MDS, Regular 1010404000 65,745.45
C. Certified: D. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
sixty-five thousand seven hundred forty-five pesos & 45/100
Supp
proper
Signature Signature
Printed Name JEROME C. VALETE, CPA Printed Name RONNIE S. MALLARI, PhD, CESO V
OIC-ACCOUNTANT III Position Schools Division Superintendent
Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
MELQUIADEZ S. MANALO, JR.
Official Receipt No. & Date/Other Documents