Disbursement Voucher

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DISBURSEMENT VOUCHER No.

__________________
APAYAO SCIENCE HIGH SCHOOL
San Isidro Sur, Luna, Apayao Date __________________

MODE OF PAYMENT:
MDS Check Commercial Check ADA Others

Payee/Claimant: CAGELCO II ID No./TIN

Address: Libertad, Abulug, Cagayan Responsibility Center

Particulars

Payment of electric bill for Junior High School for the month of
June 2018.

Gross Amount: P 5,025.72


Less: TAX 330.16
Php 4,695.57
Net Amount : Php 4,695.57

Amount due Php 4,695.57

A. Certified expenses necessary B. Certified supporting documents C. Approved for payment


lawful and Cash available complete and proper

STACY L. SACOPASO JAQUELYN W. OREÑA MARY JANE T. DULDULAO


SDO Designate Administrative Aide III Head Teacher I

Date: __________________ Date: __________________ Date: __________________


A. Received Payment:
Check No: __________________
Date: __________________ ALOBSNo: ___________________
__________________________ Bank: Land Bank –Luna Branch Date:_______________________
Signature over Printed Name OR No/ other relevant document JEV No. __________________
Issued: Date: __________________
Date: __________________
DISBURSEMENT VOUCHER No. __________________
APAYAO SCIENCE HIGH SCHOOL
San Isidro Sur, Luna, Apayao Date __________________

MODE OF PAYMENT:
MDS Check Commercial Check ADA Others

Payee/Claimant: CAGELCO II ID No./TIN

Address: Libertad, Abulug, Cagayan Responsibility Center

Particulars

Payment of electric bill for Senior High School for the month of
June 2018.

Gross Amount: P 4,304.15


Less: TAX 282.80
Php 4,021.35
Net Amount : Php 4,021.35

Amount due Php 4,021.35

D. Certified expenses necessary E. Certified supporting documents F. Approved for payment


lawful and Cash available complete and proper

STACY L. SACOPASO JAQUELYN W. OREÑA MARY JANE T. DULDULAO


SDO Designate Administrative Aide III Head Teacher I

Date: __________________ Date: __________________ Date: __________________


B. Received Payment:
Check No: __________________
Date: __________________ ALOBSNo: ___________________
__________________________ Bank: Land Bank –Luna Branch Date:_______________________
Signature over Printed Name OR No/ other relevant document JEV No. __________________
Issued: Date: __________________
Date: __________________

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