This Circular shall take effect fifteen (15) days from date of publication in a
newspaper of general circulation.
I II I Chairperson
~o
Coinmissioner
-.
ANNEX A
(Agency Name)
II
I I
TOTAL I
Purpose
I
I
I I herebv certiiv that the above expenses are incurred 'as they are necesserv for the above cited
I purpose, that above goods and services were acquired from parties not issuing receipts. And that I
am fully aware that wilful faisification of statements is punishable by law.
Signature , . /
/
Printed Name
I
Employee\! 1 ~
N\ V Immediate Supervisor
I Date I Date J
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<. I