General Form No.

74(A)
Revised Dec. 22, 1983
Republic of the Philippines
COMMISSION ON AUDIT

REPORT OF CASH EXAMINATION

Name of Accountable Officer: Renieboy S. Nalzaro Position : Barangay Treasurer
Agency : Barangay Bolinsong Station : LGU- Bonifacio
Maximum Cash Accountability: Amount of Bond: Risk Number: Effective Date:
P 100,000.00 P 75,000.00 62-14-1344R December 8, 2014
AUDITOR/EXAMINER: Official Designation:
Seth Rene C. Cabrera State Auditor I
A. C A S H P R O D U C T I O N N O T I C E
TO Accountable Officer: Position: Date:
Renieboy S. Nalzaro Barangay Treasurer July 30, 2015

DEMAND, is hereby is hereby made that you produce all your cash, treasury warrants, checks, money orders, cash items, paid vouchers
unused acctbl'e forms, etc., for which you are officially accountable as Barangay Treasurer Barangay Bolinsong
(Position) (Agency)
Bonifacio, Misamis Occidental and any fund, checks, treasury warrants and/or cash items in your possession held by you for deposit and
safekeeping.
NOTED AND Accountable Officer's Signature: Date: Auditor/Duly Authorized Representative's Signature:
COMPLIED
WITH (SGD.)Renieboy S. Nalzaro 07/30/15 (SGD.)
B. C A S H C O U N T
INVENTORY OF CASH ON HAND INVENTORY OF CASH ITEMS (Includes checks, treasury warrants, money orders, etc.)
Paper and Coin Amount
Denomination No. of Pcs. Amount Particulars Disallowed Allowed
P 100.00 2 P 200.00
50 2 P 100.00
NONE

Total 2 P 300.00
TOTAL INVENTORY OF CASH AND/OR ALLOWED CASH ITEMS (TO D)..

C. INVENTORY OF UNUSED ACCOUNTABLE FORMS

With Money Value Without Money Value
Name of Form Qty Inclusive Serial No. Denomination Amount Name of Form Qty. Inclusive Serial Number
AF 51 21 3142280-300
LBP Check 88 858813-900
NONE

T o t al 0 P - T o t al 109
I HEREBY CERTIFY on my offical oath: (1) That upon demand by the Auditor/Examiner I produced all my cash, treasury
warrants, checks, money orders, cash items, paid vouchers, unused accountable forms, etc., for which I am officially accountable;
(2) That the inventory of such cash, cash items and unused accountable forms in my possession and produced to the Auditor/
Examiner at the time of cash count today is correctly state above and is broken as
follows:
1) Cash and/or cash items . . . . . . . . . . . . . . . . . . . . . . P 300.00
2) Unused accountable forms with money value . . . . . P -
3) Unused accountable forms without money value . . . 109
of which (P ) was disallowed by the Auditor/Examiner and 3) That said cash, treasury warrants, checks, money orders,
cash items, paid vouchers, unused accountable forms, etc., were retuned to me intact after the cash count.
Accountable Officer's Signature: Position: Agency/Station:
Renieboy S. Nalzaro Barangay Treasurer Barangay Bolinsong
Signed in the
Presence of: Elma Pesalbon Emee Eunice Dy
 D. STATEMENT OF ACCOUNTABILITY
Nature of Funds Cash in Vault T O TALS
BALANCE, Last Examination
February 6, 2014 P 0.02 P - P - P 0.02
ADD: Debits to Accountability

February 7-28, 2014 200.00

March 1-31, 2014 550.00
April 1- June 30, 2014 214,200.00
July 1- September 30, 2014 65,047.15
October 1- December 31, 2014 1,800.00
January 1- March 31, 2015 50,600.00
April 1- June 30, 2015 61,825.41
July 1- 30, 2015 750.00

Total Debits to Accountability 394,972.58

February 7-28, 2014 -

March 1-31, 2014 -
April 1- June 30, 2014 211,500.00
July 1- September 30, 2014 62,447.15
October 1- December 31, 2014 1,500.00
January 1- March 31, 2015 55,400.02
April 1- June 30, 2015 62,825.41
July 1- 30, 2015 1,000.00

Total Credits to Accountability P 394,672.58

Balance of Accountability as of
June 10, 2015 P 300.00
Inventory of Cash and/
allowed cash items. P 300.00
Shortage or (Overage) P (0.00)
I HEREBY CERTIFY that my accountability for the above funds of Brgy. Bolinsong, Bonifacio, Mis Occ.
(Agency)
at the time of examination on July 30, 2015 is correctly stated above totalling
Three Hundred Pesos Only.

Accountable Officer's Signature: Designation: Agency/Station:

Barangay Treasurer Barangay Bolinsong

I HEREBY CERTIFY that the preceeding is a true and correct report of the examination of the Cash and Accounts of:
Name of Accountable Officer: Designation Agency/Station: Date:

Renieboy S. Nalzaro Barangay Treasurer Barangay Bolinsong 07/30/15

Remarks

Signature of Auditor/Examiner SETH RENE C. CABRERA Date: 07/30/15

1. This form will be used for the examination of all cash accountable officers in the corporate, national and local government offices.
2. Before proceeding to conduct an examination, the examiner should thoroughly familiarize himself with the revised manual on cash examination.
3. The six (6) columns on the face hereof are left blank to meet all fund requirements.
4. If space provided for is not enough, use it as summary only and support it with schedules.
5. All reports of examination with their supporting papers and letters will be forwarded to their respective Regional Directors in duplicate . In the
 event of shortage/irregularity, the procedures outlined under COA Memorandum 83-81B dated November 1983 should be strictly followed.
6. Checks treasury warrants, money orders, and other cash items shall be listed on the space for Inventory of Cash Items.
 EXHIBIT 4B
STATEMENT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS WITHOUT MONEY VALUE
AS OF July 30, 2015

Accountable Officer Renieboy S. Nalzaro Page 1

Designation Barangay Treasurer
Agency Barangay Bolinsong, Bonifacio, Misamis Occidental

Name of Balance as of last Examination Received Since Issued Since Balance of Accountability On Hand Per Actual Count Difference
Form
Qty Incl. Ser. Nos. Qty Incl. Ser. Nos. Qty Incl. Ser. Nos. Qty Incl. Ser. Nos. Qty Incl. Ser. Nos. Qty Incl. Ser. Nos.
AF 51 38 2783872-900 38 2783872-900 - - - - - -
50 1766851-900 50 1766851-900 - - - - - -
50 2892351-400 50 2892351-400 - - - - - -
50 2894701-750 50 2894701-750 - - - - - -
50 2898851-900 50 2898851-900 - - - - - -
50 3089801-850 50 3089801-850 - - - - - -
50 3142251-300 29 3142251-300 21 3142280-300 21 3412280-300 - -

LBP Check 66 662435-500 66 662435-500 - - - - - -

100 858701-800 100 858701-800 - - - - - -
100 703501-600 100 703501-600 - - - - - -
100 858801-900 12 858801-812 88 858813-900 88 858813-900 - -

TOTAL 104 600 595 109 109 0

Prepared by: I HEREBY CERTIFY that the above Statement of Accountability

for Accountable Forms without Money Value is true and correct.

30-Jul-15 (SGD.) SETH RENE C. CABRERA 30-Jul-15 (SGD.) Renieboy S. Nalzaro

Date State Auditor I Date Accountable Officer
 STATEMENT OF BANK RECONCILIATION
As of July 21 , 2015

NAME OF ACCOUNT TREASURER

Barangay Bolinsong Renieboy S. Nalzaro
AUTHORIZED DEPOSITORY ADDRESS OF DEPOSITORY
LBP - General Fund 0812-1015-52 OZAMIZ CITY
BOOK BALANCE P 72,645.20
I. ADD: Items requiring adjustment by agency:

Sub-Total P 72,645.20
II. DEDUCT: Items requiring adjustment by agency:

Sub-Total P 72,645.20

ADJUSTED BOOK BALANCE P 72,645.20

BALANCE PER BANK STATEMENT P 135,520.70

III. ADD: Deposit in transit and other items requiring adjustment by bank:
7/21/2015 Deposit In Transit 1,000.00

P 136,520.70
IV. DEDUCT: Items requiring adjustment by bank:

Sub-Total P 136,520.70
V. DEDUCT: Outstanding Checks:

M. Tauto-an 1/8/2009 C#0265496 2,000.00

M. Tauto-an 12/9/2009 C#576317 1,100.00
N. Bacus 12/29/2009 C#576318 600.00
M. Tauto-an 1/21/2010 C#576322 975.50
R. Nalzaro 7/20/2015 C#858808 56,300.00
E. Pesalbon 7/20/2015 C#858809 1,400.00
H. Manlangit 7/20/2015 C#858810 1,500.00 63,875.50

-
Sub-Total P 72,645.20

ADJUSTED BANK BALANCE P 72,645.20

Prepared by:

SETH RENE C. CABRERA

State Auditor I

Collections IRA Deposits Disb Bal

46,243.04
Jan 123,818.00 123,818.00 57,300.00 112,761.04
Feb 1,500.00 123,818.00 125,318.00 162,731.24 75,347.80
Mar 53,900.02 123,818.00 177,718.02 159,446.47 93,619.35
Apr - 123,818.00 123,818.00 96,177.04 121,260.31
May 58,725.41 123,818.00 182,543.41 266,508.56 37,295.16
Jun 4,100.00 123,818.00 127,918.00 145,337.96 19,875.20
Jul 1,000.00 123,818.00 124,818.00 72,048.00 72,645.20
 EXHIBIT 4A
STATEMENT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS WITH MONEY VALUE
As of July 30, 2015

Acctble Officer Renieboy S. Nalzaro

Designation Barangay Treasurer
Agency Barangay Bolinsong, Bonifacio, Misamis Occidental

Name Balance as of last Examination Received Since Issued Since Balance of Accountability On Hand Per Actual Count Difference
of
FORM Qty Incl. Ser. N Den. Amt. Qty Incl. Ser. No. Den. Amt. Qty Incl. Ser. No. Den. Amount Qty Incl. Ser. No. Den. Amount Qty Incl. Ser. No. Den. Amount Qty Incl. Ser. No.Den. Amt

-
-

NONE

Total 0 - P0.00 0 - P0.00 0 - P0.00

Prepared by: I HEREBY CERTIFY that the above Statement of Accountability for
Accountable Forms with Money Value is true and correct.

7/30/2015 (SGD.) SETH RENE C. CABRERA 6/10/2015 (SGD.) Renieboy S. Nalzaro

Date State Auditor I Date Accountable Officer
 2013 Cash Collection Cash Deposit Balance
June 14 Balance 5,300.00 - 5,300.00
June 50.00 - 5,350.00
July 600.00 - 5,950.00
August 550.00 - 6,500.00
September 450.00 - 6,950.00
October 100.00 - 7,050.00
November 350.00 - 7,400.00
December 450.00 - 7,850.00

2014
January 600.00 - 8,450.00
February - - 8,450.00
March 550.00 - 9,000.00
April 550.00 - 9,550.00
May 800.00 - 10,350.00
June 500.00 - 10,850.00
July - - 10,850.00
August - - 10,850.00
September 450.00 - 11,300.00
October 100.00 - 11,400.00
November 300.00 - 11,700.00
December 200.00 - 11,900.00

2015
January 400.00 - 12,300.00
February 150.00 - 12,450.00
March 450.00 - 12,900.00
April 400.00 - 13,300.00
May 600.00 - 13,900.00
June 500.00 14,423.11 (23.11)
July 150.00 1,350.00 (1,223.11)
Bagumbang 268,454.43
Montol 117,938.40
Bagumbang 353,739.66
Digson 68,967.69
Buracan -