Responsibility
Particulars MFO/PAP Amount
Center
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
GRACE M. TUNGUIA
PARPO I/OIC CAO-STOD
(Printed Name, Designation and Signature of Supervisor)
B. Accounting Entry:
Cash available
Signature: Signature:
Date: Date:
Office
Total
A. Certified: Charges to appropriation/allotment B. Certified: Allotment available and obligated
necessary, lawful and under my direct supervision, and for the purpose/adjustment necessary as indicated
supporting documents valid, proper and legal. above
Signature Signature
Printed Name GRACE M. TUNGUIA Printed Name JOSEPHINE O. CONSING
Position PARPO I/OIC CAO - STOD Position BUDGET OFFICER
Head Requesting Office/Authorized Head Budget Unit/ Authorized
Representative Representative
Date Date
C. STATUS OF OBLIGATION
Reference Amount
Date Particulars ORS/JEV/RCI/RADAI No. Obligation Payment Not Yet Due Due and Demandable
Totals
date particulars amount per head no. of pax amount
Oct. 19, 2016
Am Snacks: 75.00 10 750.00
Lunch: 250.00 10 2,500.00
Pm Snacks: 75.00 10 750.00
Dinner: 250.00 10 2,500.00
Function Room/ Venue Rental - - 4,000.00
Oct. 20, 2016 -
Am Snacks: 75.00 10 750.00
Lunch: 250.00 10 2,500.00
Pm Snacks: 75.00 10 750.00
Dinner: 250.00 10 2,500.00
Function Room/ Venue Rental - - 4,000.00
Oct. 21, 2016 -
Am Snacks: 75.00 10 750.00
Lunch: 250.00 10 2,500.00
Pm Snacks: 75.00 10 750.00
Function Room/ Venue Rental - - 3,713.00
28,713.00