DV Form
DV Form
DV Form
Fund Cluster:
01
DISBURSEMENT VOUCHER Date: August 25, 2020
DIV No.: 01
Mode of
MDS CHECK X Commercial Check ADA Others (Please specify)
Payment
_____________________
TIN/Employee No.: ORS/BURS No.:
Payee ISELCO-1
B. Accounting Entry:
Account Title UACS Code Debit Credit
Electricity Expenses
Due to BIR
Signature Signature
Date Date
Fund Cluster:
01
DISBURSEMENT VOUCHER Date: 03/21/2023
DIV No.: 01
Mode of
MDS CHECK X Commercial Check ADA Others (Please specify) CASH
Payment
_____________________
TIN/Employee No.: ORS/BURS No.:
Payee JEFFERSON M. VIDUYA
923-514-243
B. Accounting Entry:
Account Title UACS Code Debit Credit
Signature Signature
Date Date
Fund Cluster:
01
DISBURSEMENT VOUCHER Date: 12/29/2021
DIV No.: 01
Mode of
MDS CHECK X Commercial Check ADA Others (Please specify)
Payment
_____________________
TIN/Employee No.: ORS/BURS No.:
Payee ANTHONY M. GAFFUD
B. Accounting Entry:
Account Title UACS Code Debit Credit
Signature Signature
Fund Cluster:
01
DISBURSEMENT VOUCHER Date: 12/29/2021
DIV No.: 01
Mode of
MDS CHECK X Commercial Check ADA Others (Please specify)
Payment
_____________________
TIN/Employee No.: ORS/BURS No.:
Payee ALLAN P. MANSAT
B. Accounting Entry:
Account Title UACS Code Debit Credit
Signature Signature
Fund Cluster:
01
DISBURSEMENT VOUCHER Date: 12/22/2021
DIV No.: 01
Mode of
MDS CHECK X Commercial Check ADA Others (Please specify)
Payment
_____________________
TIN/Employee No.: ORS/BURS No.:
Payee INNOVE COMMUNICATIONS INC.
Address
B. Accounting Entry:
Account Title UACS Code Debit Credit
Signature Signature
Fund Cluster:
01
DISBURSEMENT VOUCHER Date: 10/14/2020
DIV No.: 01
Mode of
MDS CHECK X Commercial Check ADA Others (Please specify)
Payment
_____________________
TIN/Employee No.: ORS/BURS No.:
Payee NEW SANTIAGO LIBERTY STORE
199-331-001
B. Accounting Entry:
Account Title UACS Code Debit Credit
Signature Signature
Date Date
Fund Cluster:
01
DISBURSEMENT VOUCHER Date: 10/07/2021
DIV No.: 01
Mode of
MDS CHECK X Commercial Check ADA Others (Please specify)
Payment
_____________________
TIN/Employee No.: ORS/BURS No.:
Payee NEW SANTIAGO LIBERTY STORE
199-331-001
B. Accounting Entry:
Account Title UACS Code Debit Credit
Signature Signature
Date Date
Fund Cluster:
01
DISBURSEMENT VOUCHER Date: 8/9/2020
DIV No.: 01
Mode of
MDS CHECK X Commercial Check ADA Others (Please specify)
Payment
_____________________
TIN/Employee No.: ORS/BURS No.:
Payee SAM'S SARI SHOP
256-376-213
B. Accounting Entry:
Account Title UACS Code Debit Credit
Signature Signature
Date Date
Fund Cluster :
Mode of
MDS Check X Commercial Check ADA Others (Please specify)
Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee ISELCO-I
TIN of PAYEE ASK IN YOUR RES
Address Echague Isabela
Amount Due
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
PRINCIPAL
Printed Name, Designation and Signature of Supervisor
B. Accounting Entry:
Account Title UACS Code Debit
Electricity Expenses 422 5010203000 8,500.00
Due to BIR 108 1010404000
Cas
h
C. Certified: Approvedfor
D. Approved forPayment
Payment
Cash available 3 -2 5
Subject to Authority to Debit Account (when applicable)
Supporting documents complete and amount claimed
Electricity Expenses 422 5010203000 8,500.00
Due to BIR 108 1010404000
Cas
h
C. Certified: Approvedfor
D. Approved forPayment
Payment
Cash available 3 -2 5
Subject to Authority to Debit Account (when applicable)
Supporting documents complete and amount claimed
proper
Signature Signature
Date Date
Fund Cluster :
01
Date : Date Prepared
DV No. : 01
Please specify)
_________________
ORS/BURS No.:
ASK IN YOUR RESPECTIVE ADAS
P Amount
7,031.25
7,031.25
Debit Credit
8,500.00
8,500.00 -
8,500.00
8,500.00 -
PRINCIPAL
C, Schools Division Superintendent
ency Head/Authorized Representative
JEV No.
mber:
Date