Annex A

Republic of the Philippines

Department of Foreign Affairs
2330 Roxas Boulevard, Pasay City 1300
834 - 4000 (Trunkline)

OBLIGATION SLIP

No.:
Payee/Office: Date:
Responsibility Center:
Address:
F/P.P.A:

Account
Particulars Amount
Code

Total
A. Requested by: B. Funds Available
Certified: Charges to appropriation/allotment Certified: Appropriation/Allotment available and
necessary, lawful and under my direct obligated for the purpose as indicated
supervision above

Signature: Signature:

Printed Name: Printed Name:

Position: Position:

Date: Date:

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 Annex B

NATIONAL FOOD AUTHORITY

101 E. Rodriguez Sr. Ave., Quezon City, 1100
Philippines

BUDGET UTILIZATION SLIP

Payee/Office: No.:
Address: Date:
Responsibility Center:

Account
Particulars Amount
Code

Total
A. Requested by: B. Funds Available
Certified: Charges to budget necessary, Certified: Budget available and funds earmarked/
lawful and under my direct supervision obligated for the purpose as indicated
above
Signature: Signature:

Printed Name: Printed Name:

Position: Position:

Date: Date:

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 Annex C

Republic of the Philippines

CITY OF OLONGAPO

DISBURSEMENT VOUCHER
No.:
MODE OF PAYMENT
MDS Check Commercial Check ADA Others Date:
Payee/Office: TIN/Employee No.: OS/BUS No.:
Date:
Address: Responsibility Center
Title: Code:

Particulars Amount

Amount Due
A Certified: Supporting documents complete and proper B Approved for Payment:
Cash available
Subject to ADA (where applicable)

Signature: Signature:

Printed Name: Printed Name:

Position: Position:
(Head, Accounting Unit/Authorized Representative) (Agency Head/Authorized Representative)

Date: Date:

C Received Payment: D Journal Entry Voucher:

Check/ADA No.: _________
Signature : ________________________ Date: ___________ Date: __________ No: __________
Bank Name: _________________ Date: __________
Printed Name: __________________________________________ OR No./other relevant document
issued:

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