Annexes

Annex 1
REGISTRY OF BUDGET, COMMITMENTS, PAYMENTS AND BALANCES

MAINTENANCE AND OTHER OPERATING EXPENSES
SK of Barangay: City/Municipality: Sheet No.:
Budget Monitoring Officer: Province:
Program/Project/Activity:
Breakdown of Object of Expenditures
(Insert
Particulars Date Reference Total Amount Training Office Supplies Electricity additional
Expenses Expenses Expenses Object of
Expenditures)
a. Budget
Totals brought forward
Annual or Supplemental Budget/Adjustments
for the period:
Total Budget carried forward
b. Commitments
Commitments/Adjustments for the period:
Total Commitments carried forward
c. Payments
Payments/Adjustments for the period:
Total Payments carried forward
Balance, Available Budget (a-b)

Balance, Unpaid Commitments (b-c)
Prepared and Certified Correct by:
____________________________ __________
Signature over Printed Name Date
Budget Monitoring Officer
164
Annex 1

(RBCPB-MOOE)
INSTRUCTIONS
A. The RBCPB-MOOE shall be maintained daily by the Budget Monitoring Officer by

Program/Project/Activity to record the budget (annual and supplemental budget), commitments,
payments and balances by object of expenditures for Maintenance and Other Operating
Expenses. It shall be accomplished as follows:
1. SK of Barangay – name of the barangay SK

2. Budget Monitoring Officer – name of the Budget Monitoring Officer
3. City/Municipality – the city/municipality of the barangay
4. Province – the province of the barangay
5. Sheet No. – shall be numbered as follows:
0000 – 000
Serial number (one series for each year)
Year
6. Program/Project/Activity – specific program/project/activity
7. Particulars – nature and details of the transaction
8. Date – date of source document/transaction
9. Reference – description and/or no. of the document supporting the transaction such as SK
Resolution, OR no., PO no., DV no., Check no., etc.
10. Total Amount – total amount of the budget, commitments, payments and balances
11. Breakdown of Object of Expenditures – breakdown of budget, commitments, payments
and balances by object of expenditures
12. Budget – consists of Annual and Supplemental Budget based on SK Resolution plus totals
brought forward, if any
13. Commitments – refer to the amounts committed to be paid during the period plus totals
brought forward, if any, for any lawful expenditure made by the accountable SK official
for and in behalf of the SK
14. Payments – the actual amount paid based on the check issued plus totals brought forward,
if any
15. Totals brought forward – refer to the total amount pulled forward from previous sheet to
the current sheet under Budget, Commitments and Payments
16. Totals carried forward – refer to the total amount at the end of a sheet under Budget,
Commitments and Payments that is forwarded at the beginning of the next sheet
17. Balance, Available Budget – total budget less commitments
18. Balance, Unpaid Commitments – total commitments less payments
B. At the beginning of the year, no totals brought forward shall be reflected under the budget,
payments and commitments portion unless there is unpaid commitments from the previous
year.
C. For every added sheet, the total budget, commitments and payments shall be carried forward in
the respective portion of the succeeding sheet. The computation of the balance of available
budget and unpaid commitment shall be updated for every added sheet.
D. A new sheet shall be used at the beginning of each quarter.
E. This record shall be the basis for the preparation of the SBCPB, which shall be submitted to the
SK, as basis for the evaluation of the SK’s status of budget, to the Sangguniang Barangay and
COA Auditor concerned.
F. Every sheet shall be certified correct by the Budget Monitoring Officer and the date of signing
shall be indicated.
165
Annex 1-a
(Insert
Total Office
Particulars Date Reference Training Electricity additional
Amount Supplies
Expenses Expenses Object of
Expenses
Expenditures)
a. Budget
Annual or Supplemental Budget/Adjustments for the period:
b. Commitments
c. Payments

Reversion of Available Budget
Balance, Available Budget after reversion
____________________________ __________
166
Annex 1-a

(RBCPB-MOOE)
INSTRUCTIONS
A. The RBCPB-MOOE shall be maintained daily by the Budget Monitoring Officer by


0000 – 000
Year
if any
18. Reversion of available budget – reversion of unexpended budget bringing the Balance,
Available Budget to zero
19. Balance, Available Budget after reversion – balance of available budget after reversion
B. At the beginning of the year, no totals brought forward shall be reflected under the budget,
payments and commitments portion unless there is unpaid commitments from the previous
year.
C. For every added sheet, the total budget, commitments and payments shall be carried forward in
D. A new sheet shall be used at the beginning of each quarter.
E. At the end of the year, the unexpended balance of the approved budget shall be reverted to the
general fund of the SK bringing the “Balance, Available Budget after reversion” to zero.
F. This record shall be the basis for the preparation of the SBCPB, which shall be submitted to the
SK, as basis for the evaluation of the SK’s status of budget, to the Sangguniang Barangay and
COA Auditor concerned.
G. Every sheet shall be certified correct by the Budget Monitoring Officer and the date of signing
shall be indicated.
167
Annex 2

CAPITAL OUTLAY
Information and (Insert
Particulars Date Reference Total Amount Office communication Furniture and additional
Equipment Technology Fixtures Object of
Equipment Expenditures)
a. Budget
for the period:
b. Commitments
c. Payments

____________________________ __________
168
Annex 2

CAPITAL OUTLAY
(RBCPB-CO)
INSTRUCTIONS
A. The RBCPB-CO shall be maintained daily by the Budget Monitoring Officer by

Program/Project/Activity to record the budget (annual and supplemental budget),
commitments, payments and balances by object of expenditures for Capital Outlay. It
shall be accomplished as follows:

3. City/Municipality – the city or municipality of the barangay
0000 – 000
Year
9. Reference - description and/or no. of the document supporting the transaction such
as SK Resolution, OR no., PO no., DV no., Check no., etc.
11. Breakdown of Object of Expenditures – breakdown of budget, commitments,
payments and balances by object of expenditures
12. Budget – consists of Annual and Supplemental Budget based on SK Resolution
plus totals brought forward, if any
13. Commitments – refer to the amounts committed to be paid during the period plus
totals brought forward, if any, for any lawful expenditure made by the accountable
SK official for and in behalf of the SK
14. Payments – the actual amount paid based on the check issued plus totals brought
forward, if any
15. Totals brought forward – refer to the total amount pulled forward from previous
sheet to the current sheet under Budget, Commitments and Payments
16. Totals carried forward – refer to the total amount at the end of a sheet under
Budget, Commitments and Payments that is forwarded at the beginning of the next
sheet
B. For every added sheet, the total budget, commitments and payments shall be carried
forward in the respective portion of the succeeding sheet. The computation of the
balance of available budget and unpaid commitment shall be updated for every added
sheet.
C. A new sheet shall be used at the beginning of each quarter.
D. This record shall be the basis for the preparation of the SBCPB, which shall be
submitted to the SK, as basis for the evaluation of the SK’s status of budget,
Sangguniang Barangay and COA Auditor concerned.
E. Every sheet shall be certified correct by the Budget Monitoring Officer and the date of
signing shall be indicated.
169
Annex 2-a
CAPITAL OUTLAY
Particulars Date Reference Total Amount Office communication Furniture and additional
Equipment Technology Fixtures Object of
a. Budget
for the period:
b. Commitments
c. Payments

Reversion of Available Budget
Balance, Available Budget after reversion
____________________________ __________
170
Annex 2-a

CAPITAL OUTLAY
(RBCPB-CO)
INSTRUCTIONS
A. The RBCPB-CO shall be maintained daily by the Budget Monitoring Officer by

payments and balances by object of expenditures for Capital Outlay. It shall be accomplished as
follows:

0000 – 000
Year
9. Reference - description and/or no. of the document supporting the transaction such as SK
if any
18. Reversion of available budget – reversion of unexpended budget bringing the Balance,
Available Budget to zero
19. Balance, Available Budget after reversion – balance of available budget after reversion
B. For every added sheet, the total budget, commitments and payments shall be carried forward in
D. This record shall be the basis for the preparation of the SBCPB, which shall be submitted to the
SK, as basis for the evaluation of the SK’s status of budget, Sangguniang Barangay and COA
Auditor concerned.
E. Every sheet shall be certified correct by the Budget Monitoring Officer and the date of signing
shall be indicated.
171
Annex 3
REGISTRY OF SPECIFIC PURPOSE FUND, COMMITMENTS, PAYMENTS AND BALANCES

(Insert
Particulars Date Reference Total Amount Training Office Supplies Electricity additional
Expenses Expenses Expenses Object of
Expenditures)
a. Specific Purpose Fund
Specific Purpose Fund for the period:
Total Specific Purpose Fund carried forward
b. Commitments
c. Payments
Balance, Available Specific Purpose Fund (a-b)

____________________________ __________
172
Annex 3
REGISTRY OF SPECIFIC PURPOSE FUND, COMMITMENTS,

PAYMENTS AND BALANCES
(RSPFCPB-MOOE)
INSTRUCTIONS
A. The RSPFCPB-MOOE shall be maintained daily by the Budget Monitoring Officer by

Program/Project/Activity to record the funds received with specific purpose, commitments,

0000 – 000
Year
6. Program/Project/Activity – specific program/project
Resolution, OR no., Po no., DV no., Check no., etc.
10. Total Amount – total amount of the specific purpose fund, commitments, payments and
balances
11. Breakdown of Object of Expenditures – breakdown of specific purpose fund,
commitments, payments and balances by object of expenditures
12. Specific Purpose Fund – fund received for a specific purpose plus totals brought forward,
if any. It shall be covered by an SK Resolution
if any
the current sheet under Specific Purpose Fund, Commitments and Payments
16. Totals carried forward – refer to the total amount at the end of a sheet under Specific
Purpose Fund, Commitments and Payments that is forwarded at the beginning of the next
sheet
17. Balance, Available Specific Purpose Fund – total specific purpose fund less
commitments
B. For every added sheet, the total specific purpose fund, commitments and payments shall be
carried forward in its respective portion in the succeeding sheet. The computation of the
balance of available specific purpose fund and unpaid commitment shall be updated for every
added sheet.
D. This record shall be the basis for the preparation of the SSPFCPB, which shall be submitted to
the SK, as basis for the evaluation of the SK’s status of specific purpose fund, Sangguniang
Barangay and COA Auditor concerned.
shall be indicated.
173
Annex 4
REGISTRY OF SPECIFIC PURPOSE FUND, COMMITMENTS, PAYMENTS AND BALANCES

CAPITAL OUTLAY
Particulars Date Reference Total Amount Office communication Furniture additional
Equipment Technology and Fixtures Object of
a. Specific Purpose Fund
Specific Purpose Fund for the period:
Total Specific Purpose Fund carried forward
b. Commitments
c. Payments
Balance, Available Specific Purpose Fund (a-b)

____________________________ __________
174
Annex 4
REGISTRY OF SPECIFIC PURPOSE FUND, COMMITMENTS,

CAPITAL OUTLAY
(RSPFCPB-CO)
INSTRUCTIONS
A. The RSPFCPB-CO shall be maintained daily by the Budget Monitoring Officer by
Program/Project/Activity to record the funds received with specific purpose, its commitments,
payments and balances by object of expenditures for Capital Outlay. It shall be accomplished as
follows:

0000 – 000
Year
10. Total Amount – total amount of the specific purpose fund, commitments, payments and
balances
11. Breakdown of Object of Expenditures – breakdown of specific purpose fund,
commitments, payments and balances by object of expenditures
12. Specific Purpose Fund – fund received with specific purpose plus totals brought forward,
if any. It shall be covered by an SK Resolution
if any
the current sheet under Specific Purpose Fund, Commitments and Payments
16. Totals carried forward – refer to the total amount at the end of a sheet under Specific
Purpose Fund, Commitments and Payments that is forwarded at the beginning of the next
sheet
17. Balance, Available Specific Purpose Fund – total specific purpose fund less
commitments
B. For every added sheet, the total specific purpose fund, commitments and payments shall be
carried forward in the respective portion of the succeeding sheet. The computation of the
balance of available specific purpose fund and unpaid commitment shall be updated for every
added sheet.
D. This record shall be the basis for the preparation of the SSPFCPB, which shall be submitted to
the SK, as basis for the evaluation of the SK’s status of specific purpose fund, Sangguniang
Barangay and COAs Auditor concerned.
shall be indicated.
175
Annex 5
REGISTER OF CASH RECEIPTS, DEPOSITS AND OTHER RELATED FINANCIAL TRANSACTIONS

SK of Barangay: City/Municipality:
SK Treasurer: Province:
Fund: Sheet No.:
Cash on Hand BREAKDOWN OF RECEIPTS/DIRECT DEPOSIT
Refund of
Direct Subsidy Grants and Donations in Cash (Additional
Date Reference Name of Payor Cash Others
Particulars Receipt Deposit Balance Deposit from With Specific
Without receipt
Specific accounts)
Advances
Barangay Purpose
Purpose
Totals/Balance
brought forward
Totals for the

quarter
Totals/Balance
carried forward
___________________________ ____________
SK Treasurer
176
Annex 5
REGISTER OF CASH RECEIPTS, DEPOSITS AND OTHER RELATED

FINANCIAL TRANSACTIONS
(RCRD)
INSTRUCTIONS
A. The RCRD shall be maintained by the SK Treasurer to record daily receipts/collections and
deposits and monitor the balance of Cash on Hand under his/her accountability. It shall also be
used to monitor any adjustments affecting Cash on Hand and to account for the refund of cash
advances which shall be presented in the Notes to Financial Statements. It shall be
accomplished as follows:
1. SK of Barangay – name of the Barangay SK

2. SK Treasurer – name of the SK Treasurer
5. Fund – name of fund such as General Fund or any other authorized fund
0000 – 000
Year
8. Reference – serial number of the ORs issued including the cancelled ones listed in
numerical sequence for the receipts/collections in cash or check; Validated Deposit Slips
(VDS) for deposits of receipts/collections covered by OR; and VDS/credit memos for
direct deposits to SK’s bank account
9. Name of Payor – name of individual/entity making the payment
10. Particulars – nature and details of the transactions
11. Cash on Hand:
a. Receipt – amount of collections per OR
b. Deposit – amount of deposit with Government-Owned Bank (GOB)/Authorized
Government Depository Bank (AGDB) per VDS
c. Balance – balance of undeposited collection
12. Direct Deposit – amount deposited directly to the GOB/AGDB account of the SK
13. Breakdown of Receipts/Direct Deposit:
- Subsidy from Barangay – amount received equivalent to ten percent share from the
General Fund of the Barangay
- Grants and Donations in Cash – grants and donations in cash received from
individuals, private sector or international institutions with or without restrictions or
conditions
Note: Additional receipt accounts may be assigned in the blank columns under Breakdown
of Receipts/Direct Deposit and additional columns may be added as needed.
14. Refund of Cash Advances – amount received from an accountable SK Official
representing unexpended portion of cash advance granted
15. Others – amount of other adjustments involving cash on hand
16. Totals/Balance brought forward – refer to the total amount/balance pulled forward from
previous sheet to the current sheet
17. Totals for the quarter – refer to the total amount of transactions for the quarter
18. Totals/Balance carried forward – refer to the total amount/balance at the end of a sheet
that is forwarded at the beginning of the next sheet
B. A new sheet shall be used at the beginning of each quarter.
C. At the end of year, the balance of the Cash on Hand are carried forward to the succeeding year
except the totals under the column “Breakdown of Receipts/Direct Deposit”.
D. Every sheet shall be certified correct by the SK Treasurer and the date of signing shall be
indicated.
177
Annex 6
REGISTER OF CASH IN BANK AND OTHER RELATED FINANCIAL TRANSACTIONS

SK Treasurer: Province:
Fund: Sheet No.
BREAKDOWN OF WITHDRAWALS/PAYMENTS Withholding tax
Cash in Bank Maintenance and Other
Name of Capital Outlay Advances (Specify the (Specify the
Date Reference Particulars Operating Expenses Others
Payee type of type of
(Additional (Additional Advances Advances to withholding withholding
Travelling Office
Deposit Withdrawal Balance payment payment to SK SK tax) tax)
Expenses Equipment
accounts) accounts) Officials Treasurer
Totals/Balance
brought forward
Totals for the

quarter
Totals/Balance
carried forward
___________________________ ____________
SK Treasurer
178
Annex 6
REGISTER OF CASH IN BANK AND OTHER RELATED FINANCIAL

TRANSACTIONS
(RCB)
INSTRUCTIONS
A. The RCB shall be maintained by the SK Treasurer to record daily deposits and
withdrawals/payments and monitor the balance of Cash in Bank under his/her accountability. It
shall also be used to monitor any adjustments affecting Cash in Bank and to account for the
withholding taxes. It shall be accomplished as follows:
1. SK of Barangay – name of the Barangay SK
5. Fund – name of fund such as General Fund or any other authorized fund
0000 – 000
Year
7. Date – date of the source document/transaction
8. Reference – the number of the documents such as Credit Memo (CM) No., DV No.,
Check No., Validated Deposit Slip, etc.
9. Name of Payee – name of individual/entity indicated in the check/ADA
10. Particulars – nature and details of the transactions
11. Cash in Bank
a. Deposit – amount deposited in the account of the SK per VDS or CM No.
b. Withdrawal – amounts of checks/ADA issued by the SK Treasurer charged to the
account of the SK
c. Balance – daily balance of Cash in Bank
12. Breakdown of Withdrawals/Payments:
- Maintenance and Other Operating Expenses – amount spent for operating expenses
- Capital Outlay – amount spent for the purchase/construction of property and
equipment
- Advances to SK Officials – amount of cash advance granted to SK Officials for
official travel. Amount shall be entered as a negative entry upon liquidation of cash
advance
- Advances to SK Treasurer – amount of cash advance granted to SK Treasurer for
special purpose/time-bound undertakings. Amount shall be entered as a negative entry
upon liquidation of cash advance.
Note: Additional payment accounts may be assigned in the blank columns of Maintenance
and Other Operating Expenses and Capital Outlay under Breakdown of
Withdrawals/Payments, and additional columns may be added as needed
13. Others – amount of other adjustments involving cash in bank
14. Withholding Tax – amount of tax withheld from the suppliers/payees for the purchase of
goods and services. Amount shall be recorded as a negative entry upon remittance of the
withholding tax. Indicate the type of withholding tax.
16. Totals for the quarter – refer to the total amount of transactions for the quarter
B. A new sheet shall be used at the beginning of each quarter.
C. At the end of year, the balance of the Cash in Bank are carried forward to the succeeding year
except for the totals under the column “Breakdown of Withdrawals/Payments”.
D. Every sheet shall be certified correct by the SK Treasurer and date of signing shall be indicated.
179
Annex 7
DISBURSEMENT VOUCHER
SK of Barangay: DV No.:
City/Municipality: Date :
Province:
Payee:
Address:
TIN:
Particulars Amount
A. Certified as to availability B. Certified as to availability C. Certified as to necessity,

of the budget or funds received of cash, and completeness and validity, propriety, and legality
for specific purpose propriety of supporting of claim; and Approved for
documents payment:
_______________________ _________________________ ________________________

(Signature Over Printed Name) (Signature Over Printed Name) (Signature Over Printed Name)
Budget Monitoring Officer SK Treasurer SK Chairperson
Date : ____________ Date : _____________ Date : ______________
D. Received Payment: Check No.:
Date:
Bank
________________________________
Name:
Signature Over Printed Name of Payee/ Bank
Authorized Representative Branch:
___________________ OR No.:
Date Date:
180
Annex 7
DISBURSEMENT VOUCHER
(DV)
INSTRUCTIONS
A. This form shall be used by the SK Treasurer to pay individuals/entities/creditors for

goods purchased by or services rendered to the SK. It shall be accomplished as follows:

4. Payee – name of individual/entity to whom the payment is to be made
5. Address – address of the claimant/payee
6. TIN – Tax Identification Number of the claimant/payee
7. DV No. – shall be numbered as follows:
0000 – 00 – 000

Month
Year
8. Date – date of preparation of the DV
9. Particulars – brief description of the expenses to be paid
10. Amount – amount to be paid
11. Box A – Certification of the Budget Monitoring Officer as to availability of the
budget based on the Registry of Budget, Commitments, Payments and Balances or
availability of funds received for specific purpose based on the Registry of Specific
Purpose Fund, Commitments, Payments and Balances
12. Box B – Certification of the SK Treasurer as to availability of cash based on
Register of Cash in Bank and Other Related Financial Transactions and as to
completeness and propriety of supporting documents
13. Box C – Certification of the SK Chairperson as to the necessity, validity, propriety
and legality of the claim and approval of the SK Chairperson on the payment
covered by the DV
14. Box D – acknowledgement by the claimant/payee or his/her duly authorized
representative of the receipt of the check. The claimant/payee or his/her duly
authorized representative shall sign and indicate the date of receipt of the check,
the number and date of the check, and bank’s name and branch, and number and
date of the official receipt/other relevant documents issued to acknowledge receipt
of payment.
B. The DV shall be prepared in four copies to be distributed as follows:
Original copy - COA Auditor

2nd copy - SK Treasurer
3rd copy - Budget Monitoring Officer
4th copy - Claimant/Payee
181
Annex 8
SK of Barangay ____________
City/Municipality___________
Province __________________
SK CHAIRPERSON’S CERTIFICATION
SKCC No.: ___________
Date: ________________
To: The Bank Manager

(Name of Bank)
(Address)
Sir/Madam:
This is to certify that the following checks were duly issued by SK of Barangay _______,
(Ito ay pagpapatunay na ang mga tseke na nakalista sa ibaba ay na-isyu ng SK ng Barangay __________,
complete with respective Disbursement Vouchers and supporting documents.

na kompleto ng kani-kanilang Disbursement Vouchers at kalakip na mga dokumento.)
Account No. Check No. Date Payee Amount Purpose
The undersigned attests to the truthfulness of the foregoing facts, under pain of
(Pinapatotohanan ng may lagda ang mga nakasaad sa itaas batid ang
liability for falsification, pursuant to Article 171(4) of the Revised Penal Code of the Philippines.
pananagutan sa kasong “Falsification”, sang-ayon sa Artikulo 171(4) ng Revised Penal Code ng Pilipinas.)
Very truly yours,
SK Chairperson
Delivered by: Received by:
_________________________
SK Treasurer Bank Representative
Date: ____________________ Date: ____________________
182
Annex 8
SK CHAIRPERSON’S CERTIFICATION
(SKCC)
INSTRUCTIONS
A. SKCC is prepared by the SK Treasurer, signed by the SK Chairperson and submitted

to Government-Owned Bank/Authorized Government Depository Bank
(GOB/AGDB) to enable payees to encash/negotiate the issued checks of the SK. It

4. SKCC No. – shall be numbered as follows:
0000 - 00 - 000
Serial number (one series each year)

Month
Year
5. Date – the date of preparation of the SKCC
6. Certification details:
a. Certification issued by SK of Barangay – name of the barangay SK (e.g.
SK of Barangay Commonwealth)
b. Account No. – account number of the current account maintained with
GOB/AGDB
c. Check No. – number indicated in the check issued
d. Date – date of the check
e. Payee – name of payee
f. Amount – amount of check issued
g. Purpose – purpose of the transaction
7. Very truly yours – signature over printed name of the SK Chairperson
8. Delivered by – signature over printed name of the SK Treasurer and the date
the SKCC was transmitted/delivered to GOB/AGDB
9. Received by – signature over printed name of the bank representative and the
date the SKCC was received
B. The SKCC shall be prepared in four copies to be distributed as follows:
Original copy – GOB/AGDB

2nd copy – COA Auditor
3rd copy – SK Treasurer
4th copy – SK Chairperson
183
Annex 9
LIQUIDATION REPORT LR No.:

_____________________________________
SK of Barangay, City/Municipality, Province Date:
PARTICULARS AMOUNT
TOTAL AMOUNT SPENT
AMOUNT OF CASH ADVANCE PER DV NO._____DTD._____
AMOUNT REFUNDED PER O.R. NO.________DTD.__________
AMOUNT TO BE REIMBURSED
A. Certified: Correctness of the B. Certified: Purpose of cash C. Certified: Supporting

above data advance duly accomplished documents are complete and
proper
________________________ _________________________ _________________________

Signature over Printed Name Signature over Printed Name Signature over Printed Name
Accountable SK Official SK Chairperson SK Treasurer
___________________ ___________________ ___________________

Date Date Date
184
Annex 9
LIQUIDATION REPORT
(LR)
INSTRUCTIONS
A. This form shall be used to liquidate cash advances made by the accountable SK official.
It shall be accomplished as follows:
1. SK of Barangay, City/Municipality, Province – name of the barangay SK, city/

municipality and province of the barangay
2. LR No. – the LR shall be numbered as follows:
0000 – 00 – 000

Month
Year
3. Date – date of preparation of the LR
4. Particulars – brief description of the cash advance being liquidated and the details
of the expenses covered by the report
5. Amount – the corresponding amount of expenses/payments made out of the cash
advance
6. Total Amount Spent – total payments/amount spent
7. Amount of Cash Advance – amount of cash advance received and the number and
date of the Disbursement Voucher (DV)
8. Amount Refunded – amount returned representing excess/unexpended cash
advance and the number and date of the Official Receipt (OR) covering the refund
made
9. Amount to be Reimbursed – excess of the total amount spent over the cash
advance. A new DV shall be prepared for the reimbursement.
10. Box A. Certified: Correctness of the above data – signature over printed name of
the accountable SK official and date of certification
11. Box B. Certified: Purpose of cash advance duly accomplished – signature over
printed name of the SK Chairperson and date of certification.
12. Box C. Certified: Supporting documents are complete and proper – signature
over printed name of the SK Treasurer and date of certification.
B. The LR shall be supported by required documents.
C. The LR shall be prepared and distributed as follows:
 Cash advance for travel – four copies

Original copy – COA Auditor
2nd copy – SK Treasurer
3rd copy – Budget Monitoring Officer
4th copy – Accountable SK Official
 Cash advance for specific purpose – three copies

3rd copy – Budget Monitoring Officer
185
Annex 10
SUBSIDIARY LEDGER FOR CASH ADVANCES

SK of Barangay:
City/Municipality:
Province:
SK Treasurer:
Accountable SK Official:
Position/Designation:
Amount
Date Particulars Reference Cash Advance/ Liquidation/
Balance
Reimbursement Refund
___________________________ ____________
SK Treasurer
186
Annex 10
SUBSIDIARY LEDGER FOR CASH ADVANCES

(SLCA)
INSTRUCTIONS
A. This ledger is used by the SK Treasurer to monitor the grant/reimbursement and

liquidation/refund of cash advances of SK Officials. A separate SLCA shall be
maintained for each accountable SK Official. It shall be accomplished as follows:

4. SK Treasurer – name of SK Treasurer
5. Accountable SK Official – name of accountable SK Official who made the cash
advance
6. Position/Designation – position or designation of the accountable SK Official
7. Date – date of the source documents (Check No., OR No., LR No., etc.)
8. Particulars – description of the transaction like grant, liquidation and/or refund of
cash advance, and reimbursement made to the accountable SK Official
9. Reference – reference document such as Check No., OR No., LR No., etc.
10. Cash Advance/Reimbursement – amount of cash advance granted or
reimbursements made
11. Liquidation/Refund – amount spent per Liquidation Report or refunds of
excess/unexpended cash advance
12. Balance – the difference between the Cash Advance/Reimbursement and
Liquidation/Refund
187
Annex 11
LOGBOOK OF CHECKS ISSUED AND CANCELLED

____________________________________________
SK of Barangay, City/Municipality, Province
Name of Signature of
Name of Signature Date Date
Date Check No. Particulars Authorized Authorized
Payee of Payee Received Received
Representative Representative
188
Annex 11
LOGBOOK OF CHECKS ISSUED AND CANCELLED

(LCIC)
INSTRUCTIONS
A. The Logbook shall be maintained by the SK Treasurer to record all checks issued and
cancelled. It shall be accomplished as follows:
1. SK of Barangay, City/Municipality, Province – name of the barangay SK,

City/Municipality, Province of the barangay
2. Date – date of the check
3. Check No. – number of the check issued. It shall be listed numerically
5. Name of Payee – name of payee appearing on the check
6. Signature of Payee – signature of payee
7. Date Received – date of receipt of the check by the payee
8. Name of Authorized Representative – name of payee’s authorized representative
to receive the check.
9. Signature of Authorized Representative – signature of payee’s authorized
representative
10. Date Received – date of receipt of the check by the payee’s authorized
representative.
189
Annex 12
SK of Barangay, City/Municipality, Province
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant of COA Circular No. 2017-001 dated June 19, 2017
Name
Particulars Amount
TOTAL
Purpose
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose,
that above goods and services were acquired from parties not issuing receipts. And that I am fully aware
that willful falsification of statements is punishable by law.
Certified Correct by: Noted by:

Signature
Printed
Name
SK Official SK Chairperson
Date Date
190
Annex 12
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

(CENRR)
INSTRUCTIONS
A. This form shall be used to support expenses amounting to Three hundred pesos (P300)
or less which need not be issued official receipts/invoice. It shall be accomplished as
follows:
1. SK of Barangay/City/Municipality, Province – name of the barangay SK,

City/Municipality and Province of the barangay
2. Name – the name of the SK official who paid the expenses
3. Particulars – details of payments
4. Amount – the amount of payment made
5. Total – total payments made
6. Purpose – the purpose for which the payment/s was/were made
7. Certified Correct by: – signature over printed name of the SK official who paid
the expenses and the date of signing
8. Noted by: – signature over printed name of the SK Chairperson and the date of
signing
191
Annex 13
REIMBURSEMENT EXPENSE RECEIPT
SK of Barangay: RER No.:

City/Municipality: Date:
Province:
RECEIVED from ____________________________________________,

(Name)
_________________________________________________ the amount
(Official Designation)
of ___________________________________________ (P__________)
(In Words) (in Figures)
in payment for _______________________________________________
(Payments for subsistence, services,
___________________________________________________________
rental or transportation should show inclusive dates,
___________________________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Signature __________________________________________
Address ________________________________________________
WITNESS
Name/Signature __________________________________________
Address ________________________________________________
192
Annex 13
REIMBURSEMENT EXPENSE RECEIPT

(RER)
INSTRUCTIONS
A. This form shall be used to support expenses which cannot be conveniently issued
official receipts/invoice. It shall be accomplished as follows:

4. RER No. – the RER shall be numbered as follows:
0000 – 00 – 000

Month
Year
5. Date – date of preparation of the RER
6. Name – the name of the SK official who travelled/paid the expenses
7. Official Designation – the official designation or position of the SK official who
travelled/paid the expenses
8. In words – the amount in words of the actual payment made by the SK official
who travelled/paid the expenses
9. In figures – the amount in figures of the actual payment made by the SK official
who travelled/paid the expenses
10. Payments – the payments for subsistence, services, rental or transportation which
show inclusive dates, purpose, distance, inclusive points of travel, etc.
11. Payee – the name, signature and the address of the payee
12. Witness – the name, signature and the address of the witness to the actual payment
made by the SK official who travelled/paid the expenses
193
Annex 14
PURCHASE REQUEST
SK of Barangay:.______________________________________ PR No.: ____________
City/Municipality: _____________________________________ Date: ______________
Province: ____________________________________________
Unit of Estimated Estimated
Item No. Qty. Item description
Measurement Unit Cost Amount
Total Estimated Amount

Purpose:
Requested by: Approved by:
_________________________ _________________________
Signature over Printed Name Signature over Printed Name
Requesting SK Official SK Chairperson
_____________ _____________
Date Date
194
Annex 14
PURCHASE REQUEST
(PR)
INSTRUCTIONS
A. This form shall be prepared by the Requesting SK Official for the procurement of
supplies and materials/property and equipment. It shall be the basis in preparing the
Purchase Order (PO). This form shall be accomplished as follows:
1. SK of Barangay – name of SK of barangay

4. PR No. – the PR shall be numbered as follows:
0000 00 000
Month
Year
5. Date – date of PR preparation
6. Item No. – number assigned to the item by the SK Treasurer
7. Qty. – quantity of the item/s requested
8. Unit of Measurement – unit of measurement of the item/s requested e.g., box,
bottle, piece, etc.
9. Item Description – brief description of the item/s requested
10. Estimated Unit Cost – estimated cost per unit of the item/s requested
11. Estimated Amount – estimated total amount of the item/s requested
12. Total Estimated Amount – total estimated amount of all the items specified in the
request
13. Purpose – a brief explanation on the purpose of the request
14. Requested by – signature over printed name of the Requesting SK Official
requesting the purchase of supplies and materials/property and equipment and the
date of request
15. Approved by – signature over printed name of the SK Chairperson and the date of
approval of the PR
B. The PR shall be prepared in three copies to be distributed as follows:
Original – attachment to the PO

2nd copy – Requesting SK Official
195
Annex 15
PURCHASE ORDER
Tel. No.: Province:
Supplier: _____________________________________________ PO No.: ___________________________
Address: _____________________________________________ Date: ______________________________
Tel. No.:_____________________TIN: ____________________ Mode of Procurement: ________________
Gentlemen: Please deliver to this office the following articles subject to the terms and conditions contained herein:
Place of Delivery: ___________________________ Delivery Term: _____________________________
Date of Delivery: ___________________________ Payment Term: _____________________________
Unit of
Item No. Item Description Quantity Unit Cost Amount
Measurement
(Total Amount in words)
In case of failure to make full delivery within the time specified above, a penalty of one-tenth (1/10) of one percent for every day of delay shall be imposed
on the undelivered item/s.
Conforme: Very truly yours,
__________________________________ _______________________________________
Signature over Printed Name of Supplier Signature over Printed Name of SK Chairperson
______________ _______________
Date Date
Availability of the budget or funds received for specific purpose:
_____________________________________________________ ____________________
Signature over Printed Name of Budget Monitoring Officer Date
196
Annex 15
PURCHASE ORDER
(PO)
INSTRUCTIONS
A. The PO is a form to be prepared by the SK Treasurer and approved by the SK Chairperson
addressed to a supplier, to deliver specific quantity/ies of goods/supplies and materials/property
and equipment subject to the terms and conditions contained therein. It shall be accomplished
as follows:
2. Tel. No. – contact telephone number of the barangay SK
5. Supplier/Address/Tel. No./TIN – name, address, telephone number and Tax Identification
Number of the supplier
6. PO No. – the PO shall be numbered as follows:
0000 – 00 – 0000

Month
Year
7. Date – date of preparation of the PO
8. Mode of Procurement – mode of procurement such as public bidding, negotiated
purchase, over-the-counter, through Procurement Service, etc.
9. Place/Date of Delivery – place and definite date/s of delivery, if not stated shall mean
seven calendar days after the receipt of the PO by the supplier
10. Delivery Term – delivery term e.g., Freight on Board (FOB) destination, FOB shipping
point.
11. Payment Term – specified period required when the delivered item/s shall be paid and
discounts allowed such as 2/10, n/30
13. Unit of Measurement – unit of measurement of the item being procured e.g., box, bottle,
piece, etc.
14. Item Description – brief description of the item being procured
15. Quantity – quantity of the item being procured
16. Unit Cost – cost per unit of the item being procured
17. Amount – total amount of the item being procured
18. Penalty Clause – penalty to be imposed to a supplier in case of non-compliance with the
delivery term of the PO
19. Conforme – signature over printed name of the supplier or his/her duly authorized
representative signifying his/her approval to the terms and conditions set by the SK
Chairperson and the date of signing by the supplier
20. Very truly yours – signature over printed name of the SK Chairperson and the date of
signing
21. Availability of the budget or funds received for specific purpose – signature over printed
name of the Budget Monitoring Officer and date of certification
B. It shall be prepared in four copies to be distributed as follows:
Original copy – attachment to the Disbursement Voucher upon request for payment
3th copy – to be submitted to COA within five (5) days after perfection of the PO
4th copy – Supplier
197
Annex 16
INSPECTION AND ACCEPTANCE REPORT

SK of Barangay: IAR No.:
Province:
Supplier: ____________________________________________ Invoice No.: ___________
PO No.: ____________________ Date: ___________________ Date: _________________
Requesting SK Official: ______________________________
Unit of
Item No. Item Description Quantity
Measurement
INSPECTION ACCEPTANCE
Date Inspected: _______________________ Date Received:___________________
Inspected, verified as to quantity Complete

and specifications
Partial (Pls. specify quantity

Received)
____________________________ ____________________________
Head, Inspection and Appraisal Committee SK Treasurer
198
Annex 16
INSPECTION AND ACCEPTANCE REPORT

(IAR)
INSTRUCTIONS
A. This report is prepared by the SK Treasurer on the inspection and acceptance of the
purchased and delivered supplies and materials/property and equipment. It shall be
4. IAR No. – the IAR shall be numbered as follows:
0000-00-000

Month
Year
5. Date – date of preparation of the IAR
6. Supplier – name of the supplier
7. PO No. – number of the Purchase Order (PO)
8. Date – date of the PO
9. Requesting SK Official – name of the requesting SK Official
10. Invoice No. – number of the Invoice
11. Date – date of the Invoice
13. Item Description – brief description of the item/s purchased and delivered
14. Unit of measurement – unit of measurement of the item/s purchased and delivered
e.g., box, bottle, piece, etc.
15. Quantity – quantity of item/s purchased and delivered
B. This report shall be signed by the Head of the Inspection and Appraisal Committee who
will conduct the inspection and verification of the item/s to determine if the item/s
delivered conforms/conform to the specifications in the PO, and shall indicate the date
of inspection.
C. The SK Treasurer shall acknowledge receipt of the item/s by signing over his/her
printed name in the “Acceptance” portion of the IAR and shall indicate a check “”
mark whether a complete or partial (specify quantity received) delivery was made and
the date of acceptance.
D. The IAR shall be prepared in three copies to be distributed as follows:
Original copy – attachment to the DV together with the original
PO/Contract, PR and other supporting documents
2nd copy – Inspection and Appraisal Committee
199
Annex 17
STOCK CARD
SK of Barangay : Article: Sheet No.:

SK Treasurer : Item Description:
City/Municipality: Unit of Measurement:
Province: Stock No.:
Issues/Losses/
Receipts Transfers/Disposals Balance
Date Reference Particulars (a) (b) (Balance+a-b) Remarks
Total Total Total
Quantity Unit Cost Quantity Quantity
Cost Cost Cost
Totals/Balance brought
forward
Totals/Balance carried
forward
200
Annex 17
STOCK CARD
(SC)
INSTRUCTIONS
A. This form shall be maintained by the SK Treasurer for each type of purchased supplies and
materials to record/monitor the receipts and issues/losses/transfers/disposals of the supplies and
materials that are within the custody of SK Treasurer. This form shall be accomplished as
follows:

5. Article – type of item or article (e.g., folder, bond paper, ball pen, stapler, etc.)
6. Item Description – brief description of the item
7. Unit of Measurement – unit of measurement of the item acquired e.g., box, bottle, piece,
etc.
8. Stock No. – number assigned by the SK Treasurer to each article
0000 – 000
Year
11. Reference – reference document used as a basis in recording the receipt or
issue/lost/transfer/disposal of the item/s such as Inspection and Acceptance Report,
Requisition and Issue Slip, Inventory Custodian Slip, Official Receipt, etc.
12. Particulars – details/description of the transaction, including name of recipients/end-users,
date of acquisition or issue/disposal and other pertinent information.
13. Receipts
- Quantity – quantity of the supplies and materials acquired through purchase
- Unit Cost – the unit cost of the supplies and materials acquired through purchase
- Total Cost – the total cost of the supplies and materials acquired through purchase
(Quantity x Unit Cost)
14. Issues/Losses/Transfers/Disposals
- Quantity – quantity of supplies and materials issued to accountable SK official/end-
user or quantity of unissued supplies and materials that were lost/transferred/disposed
- Total Cost – the total cost of the supplies and materials issued/lost/transferred/
disposed (Quantity x Unit Cost)
15. Balance
- Quantity – the difference between the quantity acquired and quantity issued/lost/
transferred/disposed
- Total Cost – the difference between the total cost of supplies and materials acquired
and total cost of supplies and materials issued/lost/transferred/ disposed (Quantity x
Unit Cost)
16. Remarks – additional information on the item/s acquired/issued/lost/transferred/disposed
201
Annex 18
ACKNOWLEDGEMENT RECEIPT FOR DONATED PROPERTY AND

EQUIPMENT/SUPPLIES AND MATERIALS
SK of Barangay: ARDPE/SM No.:

Province:
Donor’s Name: ___________________________________________________
Authorized Representative: __________________________________________
Address: _________________________________________________________
Unit of
Quantity Article Item Description Value
Measurement
Total
Purpose of Donation:
_____________________________________________________________________________
_____________________________________________________________________
Received the donated articles for the purpose stated above.
__________________________________ _____________
SK Chairperson/Authorized SK Official
Conforme:
__________________________________ _____________
Donor/Authorized Representative
202
Annex 18
ACKNOWLEDGEMENT RECEIPT FOR DONATED PROPERTY

AND EQUIPMENT/SUPPLIES AND MATERIALS
(ARDPE/SM)
Instructions
A. This form shall be prepared by the SK Treasurer, to be signed by the SK Chairperson or

his/her authorized representative, upon receipt of donated property and equipment, and
supplies and materials. It shall be accomplished as follows:

4. ARDPE/SM No. – the ARDPE/SM shall be numbered as follows:
0000-00 - 000

Month
Year
5. Date – date of preparation of the ARDPE/SM
6. Donor’s Name – name of the donor
7. Authorized Representative – the name of donor’s duly authorized representative
8. Address – address of donor or his/her authorized representative
9. Quantity – quantity of donated item/s received
10. Unit of Measurement – unit of measurement of the donated item/s received e.g.,
box, bottle, piece, etc.
11. Article – type of item or article (e.g., folder, bond paper, ball pen, stapler, sports
equipment, computer, etc.)
12. Item Description – brief description or details of the donated item/s received
13. Value – the fair value at the date of donation. If not available, the value declared
by the donor in the deed of donation or the bill of lading/airway bill/parcel notice
and other related documents shall be used.
14. Total – total value of the donated item/s received
15. Purpose of Donation – the purpose of donation as stated/specified by the donor
16. Acknowledgment Portion – signature over printed name of the SK Chairperson or
his/her duly authorized representative and the date of receipt of the donated item/s
17. Conforme – signature over printed name of the donor or his/her duly authorized
representative and the date of signing of the ARDPE/SM
B. The ARDPE/SM shall be prepared in three copies to be distributed as follows:
Original copy – Donor

2nd copy – SK Chairperson
203
Annex 19
REGISTRY OF DONATED SUPPLIES AND MATERIALS

Province: Stock No.:
Issues/Losses/
Receipts Transfers/Disposals Balance Remarks
Date Reference Particulars (a) (b) (Balance+a-b)
Total Cost/ Total Cost/ Total Cost/
Quantity Unit Cost Quantity Quantity
Fair Value Fair Value Fair Value
Totals/Balance brought
forward
Totals/Balance carried
forward
204
Annex 19
REGISTRY OF DONATED SUPPLIES AND MATERIALS

(RDSM)
INSTRUCTIONS
A. The RDSM shall be maintained by the SK Treasurer for each type of donated supplies and
materials to record/monitor the receipt and issues/losses/transfers/disposals about the supplies
and materials that are within the custody of SK Treasurer. It shall be accomplished as follows:

7. Unit of Measurement – unit of measurement of the item received e.g., box, bottle, piece,
etc.
8. Stock No. – number assigned by the SK Treasurer to each article
0000 – 000
Year
11. Reference – reference document used as a basis in recording the receipt or
issue/loss/transfer/disposal of the item/s such as Acknowledgement Receipt for Donated
Property and Equipment/Supplies and Materials, Requisition and Issue Slip, Inventory
Custodian Slip, Official Receipt, etc.
12. Particulars – details/description of the donation/transaction, including name of donors or
recipients/end-users, date of donation or issue/disposal and other pertinent information.
13. Receipts
- Quantity – the quantity of the supplies and materials acquired through donation
- Unit Cost – the unit cost of the supplies and materials acquired through donation, if
available; or indicate “Not Available” if cost cannot be determined.
- Total Cost/Fair Value – fair value of the supplies and materials acquired through
donation. If the donated item is a new one, the acquisition cost is also the fair value
14. Issues/Losses/Transfers/Disposals
- Quantity – quantity of supplies and materials issued to accountable SK official/end-
user or quantity of unissued supplies and materials that were lost/transferred/disposed
- Total Cost/Fair Value – fair value of the supplies and materials issued/lost/
15. Balance
- Quantity – the difference between the quantity received and quantity issued/lost/
- Total Cost/Fair Value – the difference between the total fair value of supplies and
materials received and total fair value of supplies and materials issued/lost/
16. Remarks – additional information on the item/s received/issued/lost/transferred/disposed
205
Annex 20
REQUISITION AND ISSUE SLIP

SK of Barangay: RIS No.:
Province:
Requisition Issue
Unit of
Stock No. Item Description Quantity Quantity Remarks
Measurement
Purpose:
Requested by: Approved by: Issued by: Received by:
Signature
Printed Name
Designation
Date
206
Annex 20
REQUISITION AND ISSUE SLIP

(RIS)
INSTRUCTIONS
A. This form shall be prepared by the requesting SK official to request issue of supplies
and materials. This form shall be accomplished as follows:

4. RIS No. – the RIS shall be numbered as follows:
0000-00-000

Month
Year
5. Date – date of preparation of the RIS
6. Requisition:
a. Stock No. – number assigned by the SK Treasurer to the item requisitioned
b. Unit of measurement – unit of measurement of the item requisitioned e.g., box,
bottle, piece, etc.
c. Item Description – brief description of the item requisitioned
d. Quantity – quantity of the item requisitioned
7. Issue:
a. Quantity – quantity of the item issued
b. Remarks – additional information regarding the item/s issued
8. Purpose – brief explanation of the purpose pertaining to the item being
requisitioned/issued
9. Requested by – signature, printed name and designation of the requesting SK
official and the date of request
10. Approved by – signature, printed name and designation of the SK Chairperson and
the date of approval
11. Issued by – signature, printed name and designation of the SK Treasurer and the
date of issue
12. Received by – signature, printed name and designation of the person who received
the item/s and the date of receipt
B. All item/s requested shall be based on the Annual Procurement Plan.
C. The RIS shall be prepared in two copies to be distributed as follows:
Original copy – SK Treasurer

2nd copy – Requesting SK Official
207
Annex 21
INVENTORY CUSTODIAN SLIP

SK of Barangay: ICS No.:
Province:
Amount
Unit of
Quantity Unit Total Item Description Stock No.
Measurement
Cost Cost
Received by: Issued by:
_____________________________ ________________________________
Signature over Printed Name and Signature over Printed Name
Designation of Recipient/End-User SK Treasurer
____________ __________
Date Date
208
Annex 21
INVENTORY CUSTODIAN SLIP

(ICS)
INSTRUCTIONS
A. This form shall be prepared by the SK Treasurer upon issue of supplies and materials
(items with unit cost below P15,000) to establish accountability of the end-users. It shall
be accomplished as follows:

4. ICS. No. – shall be numbered as follows:
0000-00-000

Month
Year
5. Date – date of preparation of the ICS
6. Quantity – number of unit/s of the supplies and materials issued to the end-user
7. Unit of Measurement – unit of measurement of the item/s issued to the end-user
e.g., box, bottle, piece, etc.
8. Amount
 Unit Cost – cost per unit of the supplies and materials issued
 Total Cost – cost of the supplies and materials issued
9. Item Description – brief description or details of the item issued to the end-user
10. Stock No. – number assigned by the SK Treasurer to the supplies and materials
issued
B. The recipient of the supplies and materials shall sign over his/her printed name in the
“Received by” portion and indicate the date of receipt of the item/s. The SK Treasurer
shall sign over his/her printed name in the “Issued by” portion and indicate the date
he/she issued the item/s.
C. The ICS shall be prepared in two copies to be distributed as follows:

2nd copy – Recipient or end-user of the supplies
and materials
209
Annex 22
ISSUE SLIP FOR DONATED PROPERTY AND EQUIPMENT/

SUPPLIES AND MATERIAL
SK of Barangay: ISDPE/SM No.:

Province:
Recipient: ___________________________________________________
Address: _________________________________________________________
Unit of
Quantity Article Item Description Value
Measurement
Total
Purpose of Donation:
_____________________________________________________________________________
_____________________________________________________________________
Approved by:
__________________________________ _____________
SK Chairperson/Authorized SK Official
Issued by:
__________________________________ _____________
SK Treasurer
Received by:
__________________________________ _____________
210
Annex 22
ISSUE SLIP FOR DONATED PROPERTY AND EQUIPMENT/

SUPPLIES AND MATERIALS
(ISDPE/SM)
Instructions
A. This form shall be prepared by the SK Treasurer, to be signed by the SK Chairperson or

his/her authorized representative and SK Treasurer, for issue of donated property and
equipment/supplies and materials to constituents. It shall be accomplished as follows:

4. ISDPE/SM No. – shall be numbered as follows:
0000 - 00 - 000

Month
Year
5. Date – date of preparation of the ISDPE/SM
6. Recipient – name of the recipient
7. Address – address of the recipient
8. Quantity – quantity of donated item/s issued
9. Unit of Measurement – unit of measurement of the donated item/s issued e.g., box,
bottle, piece, etc.
10. Article – type of item or article (e.g., folder, bond paper, ball pen, stapler, sports
equipment, computer, etc.)
11. Item Description – brief description or details of the donated item/s issued
12. Value – value/amount of the donated item/s issued
13. Total – total value/amount of the donated item/s issued
14. Purpose of Donation – the purpose of donation as indicated by the donor in the
ARDPE/SM
15. Approved by – signature over printed name of the SK Chairperson or his/her duly
authorized representative and the date of approval
16. Issued by – signature over printed name of the SK Treasurer and the date of issue
17. Received by – signature over printed name of the recipient and the date of receipt
B. In case there are many beneficiaries/recipients of the donated items, a list of

beneficiaries/recipients with signature shall be attached at the back of the ISDPE/SM.
C. The ISDPE/SM shall be prepared in three copies to be distributed as follows:
Original copy – SK Chairperson

2nd copy – Recipient
211
Annex 23
RECEIPT OF RETURNED PROPERTY AND EQUIPMENT/SUPPLIES AND MATERIALS

SK of Barangay: RRPE/SM No.:
Province:
This is to acknowledge receipt of the Property and Equipment/Supplies and Materials
Item Description Quantity PAR/ICS No. End-user Remarks
Returned by: Received by:

___________________________ _________________________
___________________ ___________________
Date Date
212
Annex 23
RECEIPT OF RETURNED PROPERTY AND EQUIPMENT/

(RRPE/SM)
INSTRUCTIONS
A. This form shall be prepared by the SK Treasurer for returned property and
equipment/supplies and materials whether serviceable or unserviceable. It shall be

4. RRPE/SM No. – shall be numbered as follows:
0000 - 00 – 000
Month
Year
5. Date – date of preparation of the RRPE/SM
6. Item Description – brief description of the returned property and
equipment/supplies and materials
7. Quantity – quantity of the returned property and equipment/supplies and materials
8. PAR/ICS No. – PAR/ICS No. of the returned property and equipment/supplies and
materials
9. End-user – name of accountable SK official/end-user returning the serviceable or
unserviceable property and equipment/supplies and materials
10. Remarks – comments (e.g. , reason for the return, cancelled PAR/ICS, and other
information)
11. Returned by – signature over printed name of the accountable SK official/end-user
returning the serviceable or unserviceable property and equipment/supplies and
materials
12. Received by – signature over printed name of the SK Treasurer signifying receipt
of the returned serviceable or unserviceable property and equipment/supplies and
materials
B. The RRPE/SM shall be prepared in three copies to be distributed as follows:
Original copy – Accountable SK Official/End-user

3rd copy – COA Auditor
213
Annex 24
INVENTORY AND INSPECTION REPORT OF UNSERVICEABLE PROPERTY

As at ___________
SK of Barangay: IIRUP No.:
City/Municipality:
Province:
INVENTORY INSPECTION AND APPRAISAL DISPOSAL
Record of Sale
Date Property/ Unit Total Date of
Particulars Qty. Fair Value Mode of Disposal Remarks OR No. and
Acquired Stock No. Cost Cost Disposal Amount
Date
Prepared and Certified Correct by: We certify to have inspected and appraised each and I certify to have witnessed the disposal of the
every article enumerated in this report. articles enumerated in this report.
____________________________ ______________________________ _____________________________

Signature over Printed Name Signature over Printed Name Signature over Printed Name
SK Treasurer Head of the Inspection and Appraisal Committee COA Authorized Representative
Date: ________________ Date: _________________ Date: ________________

Approved by:
_______________________________________ _______________
SK Chairperson
214
Annex 24
INVENTORY AND INSPECTION REPORT OF UNSERVICEABLE PROPERTY
(IIRUP)
INSTRUCTIONS
A. This report shall be prepared by the SK Treasurer to report all unserviceable property and
equipment/supplies and materials (items with unit cost below P15,000) of the SK subject to
disposal. It shall be accomplished as follows:
To be accomplished by the SK Treasurer:
1. As at _______ – period covered by the report
5. IIRUP No. – shall be numbered as follows:
0000 - 00 – 000
Month
Year
6. Date acquired – date of acquisition of the property and equipment/supplies and materials
which became unserviceable
7. Particulars – brief description of the property and equipment/supplies and materials
8. Property/Stock No. – number assigned by the SK Treasurer to the property and
9. Qty. – quantity of property and equipment/supplies and materials
10. Unit Cost – cost per unit of the property and equipment/supplies and materials
11. Total Cost – quantity multiplied by the unit cost of the property and equipment/supplies
and materials
12. Date of Disposal – date of disposal (sale, donation, destruction, etc.) of property and
13. Record of Sale
a. OR No. and Date – number of the OR issued to acknowledge receipt of proceeds of
sale of property and equipment/supplies and materials and the date of OR
b. Amount – amount received on the sale of property and equipment/supplies and
materials
14. Prepared and Certified Correct by/Date – signature over printed name of the SK
Treasurer and the date the IIRUP is signed
To be filled out by the Inspection and Appraisal Committee
15. Fair Value – fair value of obsolete and unserviceable property and equipment/supplies and
materials
16. Mode of Disposal – mode of disposing the property and equipment/supplies and materials
such as sale, donation, destruction, etc.
17. Remarks – additional information on the condition of the item/s inspected and appraised
18. Certification by/Date – signature over printed name of the head of the Inspection and
Appraisal Committee and the date of inspection
To be filled out by the witness
19. Certification by/Date – signature over printed name of COA Authorized Representative
and date of the actual disposal of the property and equipment/supplies and materials
To be filled out by the SK Chairperson
20. Approved by/Date – signature over printed name of the SK Chairperson and date of
approval
B. The IIRUP shall be prepared in two copies and distributed as follows:
215
Annex 25
PROPERTY AND EQUIPMENT CARD

Province:
Transferred/
Repair History
Receipts Property Issues Balance Lost/Disposed Balance
Date Reference Particulars (a) (b) (Balance+a-b) (c) (Balance+a-c) Remarks
Nature of
Unit Total Total Total Total Total Amount
Qty. No. Description Qty. Qty. Qty. Qty. Repair
Cost Cost Cost Cost Cost Cost
Totals/Balances
brought forward
Totals/Balances
carried forward
216
Annex 25
PROPERTY AND EQUIPMENT CARD
(PEC)
INSTRUCTIONS
A. This form shall be maintained by the SK Treasurer for each type of purchased property and equipment to
record/monitor the receipts, issues, transfers, losses and disposals and other information about the property
and equipment. It shall be accomplished as follows:
5. Article – type or classification of property and equipment (e.g., laptop/desktop computer, printer,
filing cabinet, motorcycle, etc.)
6. Item Description – brief description/specification of the property and equipment
7. Unit of Measurement – unit of measurement e.g., set, piece, etc.
0000 – 000
Year
10. Reference – number assigned to the reference document such as invoice, delivery receipt, purchase
order, Inspection and Acceptance Report, etc. (for acquisitions), Property Acknowledgement Receipt
(for issues), Property Transfer Report (for transfers), Notice of Loss (for lost property) Official
Receipt, Inventory and Inspection Report of Unserviceable Property (for disposals)
11. Particulars – details/description of the transaction, including name of recipients/end-users, date of
acquisition/issue/transfer/loss/disposal and other pertinent information.
12. Receipts
- Quantity – quantity of the property and equipment acquired through purchase
- Unit Cost – the unit cost of the property and equipment acquired through purchase
- Total Cost – the total cost of the property and equipment acquired through purchase (Quantity x
Unit Cost)
13. Property
- No. – number assigned by the SK Treasurer for each item
- Description – description of each item of property and equipment
14. Issues
- Quantity – quantity of property and equipment issued to end-user
- Total Cost – the total cost of the property and equipment issued (Quantity x Unit Cost)
15. Balance
- Quantity – quantity of unissued property and equipment
- Total Cost – total cost of unissued property and equipment (Quantity x Unit Cost)
16. Transferred/Lost/Disposed
- Quantity – quantity of property and equipment no longer needed by the SK that are transferred to
other government entity/ies, quantity of property and equipment lost, or quantity of unserviceable
property and equipment disposed
- Total Cost – total cost of transferred, lost, disposed property and equipment (Quantity x Unit
Cost)
17. Balance
- Quantity – quantity of property and equipment to be accounted for by the SK
- Total Cost – total cost of property and equipment to be accounted for the SK (Quantity x Unit
Cost)
18. Remarks – additional information on the item/s acquired/issued/transferred/lost/disposed
19. Repair History-Nature of Repair/Amount – the nature of repair (specify nature of minor or major
repair, i.e., change tire, rewiring, engine overhaul, etc.) and the cost of repair
20. Totals/Balances brought forward – refer to the total amount/balance pulled forward from previous
sheet to the current sheet
21. Totals/Balances carried forward – refer to the total amount/balance at the end of a sheet that is
forwarded at the beginning of the next sheet
217
Annex 26
REGISTRY OF DONATED PROPERTY AND EQUIPMENT

Province:
Transferred/
Repair History
Receipts Property Issues Balance Lost/Disposed Balance
(a) (b) (Balance+a-b) (c) (Balance+a-c)
Date Reference Particulars Total Total Total Total Total Remarks
Nature of
Unit Cost/ Cost/ Cost/ Cost/ Cost/ Amount
Qty. No. Description Qty. Qty. Qty. Qty. Repair
Cost Fair Fair Fair Fair Fair
Value Value Value Value Value
Totals/Balances
brought forward
Totals/Balances
carried forward
218
Annex 26
REGISTRY OF DONATED PROPERTY AND EQUIPMENT

(RDPE)
INSTRUCTIONS
A. The RDPE shall be maintained by the SK Treasurer for each type of donated property and equipment to
record/monitor the receipts, issues, transfers, losses and disposals and other information about the property
and equipment. It shall be accomplished as follows:
5. Article – type or classification of property and equipment (e.g., laptop/desktop computer, printer,
filing cabinet, motorcycle, etc.)
6. Item Description – brief description/specification of the property and equipment
7. Unit of Measurement – unit of measurement of the property and equipment e.g., set, piece, etc.
0000 – 000
Year
10. Reference – number assigned to the reference document such as Acknowledgement Receipt for
Donated Property and Equipment/Supplies and Materials (for acquisitions), Property
Acknowledgement Receipt/Issue Slip for Donated Property and Equipment/Supplies and Materials
(for issues), Property Transfer Report (for transfers), Notice of Loss (for lost property) Official
Receipt, Inventory and Inspection Report of Unserviceable Property (for disposals)
11. Particulars – details/description of the donation/transaction, including name of donors or
recipients/end-users, date of donation/issue/transfer/loss/disposal and other pertinent information
12. Receipts
- Quantity – the quantity of the property and equipment acquired through donation
- Unit Cost – the unit cost of the property and equipment acquired through donation, if available; or
indicate “Not Available” if cost cannot be determined
- Total Cost/Fair Value – fair value of the property and equipment acquired through donation. If the
donated item is a new one, the acquisition cost is also the fair value
13. Property No. – number assigned by the SK Treasurer for each item
14. Property Description – description of each item of property and equipment
15. Issues
- Quantity – quantity of property and equipment issued to end-user
- Total Cost/Fair Value – fair value of the property and equipment issued
16. Balance
- Quantity – quantity of unissued property and equipment
- Total Cost/Fair Value – fair value of unissued property and equipment
17. Transferred/Lost/Disposed
- Quantity – quantity of property and equipment no longer needed by the SK that are transferred to
other government entity/ies, quantity of property and equipment lost, or quantity of unserviceable
property and equipment disposed
- Total Cost/Fair Value – fair value of transferred, lost, disposed property and equipment.
18. Balance
- Quantity – quantity of property and equipment to be accounted for by the SK
- Total Cost/Fair Value – fair value of property and equipment to be accounted for by the SK
19. Remarks – additional information on the item received/issued/transferred/lost/disposed
20. Repair History-Nature of Repair/Amount – the nature of repair (specify nature of minor or major
repair, i.e., change tire, rewiring, engine overhaul, etc.) and the cost of repair
21. Totals/Balances brought forward – refer to the total amount/balance pulled forward from previous
sheet to the current sheet
22. Totals/Balances carried forward – refer to the total amount/balance at the end of a sheet that is
forwarded at the beginning of the next sheet
219
Annex 27
PROPERTY ACKNOWLEDGEMENT RECEIPT

SK of Barangay: PAR No.:
Province:
Unit of Property Date
Quantity Item Description Amount
Measurement No. Acquired
Received by: Issued by:
________________________ ________________________
and Designation of Recipient/End-User SK Treasurer
___________ ___________
Date Date
220
Annex 27
PROPERTY ACKNOWLEDGEMENT RECEIPT

(PAR)
INSTRUCTIONS
A. This form shall be prepared by the SK Treasurer upon issue of property and equipment
to establish accountability of the end-users. It shall be accomplished as follows:

4. PAR No. – shall be numbered as follows:
0000 - 00 - 000

Month
Year
5. Date – date of preparation of the PAR
6. Quantity – quantity of item issued to SK official or end-user
7. Unit of Measurement – unit of measurement of the item/s issued to the end-user
e.g., set, piece, etc.
8. Item Description – brief description or details of the item/s issued to the SK
official or end-user
9. Property No. – number assigned by the SK Treasurer to the property issued
10. Date Acquired – date of acquisition of the property issued
11. Amount – cost/fair value of the property issued
B. The recipient who is accountable for the property or equipment shall sign over his/her
printed name and indicate the date of receipt in the “Received by” portion of the form.
C. The SK Treasurer shall sign over his/her printed name and indicate the date of issue of
the property in the “Issued by” portion of the form
D. The PAR shall be prepared in two copies to be distributed as follows:

2nd copy – Recipient or end-user of the property and equipment
221
Annex 28
CONSTRUCTION IN PROGRESS CARD

SK of Barangay : Construction in progress:
SK Treasurer : Contract Period: ________ to ________
City/Municipality: Contract Amount:
Province: Contractor:
Name of Project: Address:
C O S T S
Date Reference Particulars Direct Direct

Overhead Consultancy Others Total Remarks
Materials Labor
222
Annex 28
CONSTRUCTION IN PROGRESS CARD

(CIPC)
INSTRUCTIONS
A. The CIPC shall be kept by the SK Treasurer for each project to record promptly the
construction costs and other information about the property and equipment. This form

5. Name of Project – complete name of the project
6. Construction in Progress – type or classification of construction in progress
(e.g., land improvements, buildings or other structures.)
7. Contract Period – period with which the project will be completed (start to
completion)
8. Contract Amount – contract price of the project
9. Contractor – name of the contractor
10. Address – address of the contractor
11. Date – date of the source document
12. Reference – the reference document such as disbursement voucher, check, etc.
13. Particulars – information or details pertaining to the transaction
14. Costs (Direct Materials, Direct Labor, Overhead, Consultancy, etc.) –
breakdown of costs paid for the project
15. Total – total cost of the project as of a specific date
16. Remarks – additional information of the property and equipment under
construction
B. Upon completion of the construction, indicate in the “remarks” portion the

reclassification to the appropriate property and equipment account.
C. Transactions shall be posted promptly based from the source documents.
223
Annex 29
PROPERTY TRANSFER REPORT
SK of Barangay: PTR No.:

City/Municipality: Transfer From:
Province: Transfer To:
Condition of the
Property
Date Acquired Description Amount Property and
Number
Equipment
Reason for transfer:
Approved by: Released by: Received by:
________________________ ________________________ ________________________

Signature over printed name Signature over printed name Signature over printed name
SK Chairperson SK Treasurer Designation
Date: ____________________ Date: ____________________ Date: ____________________
224
Annex 29
PROPERTY TRANSFER REPORT

(PTR)
INSTRUCTIONS
A. This form shall be used when there are transfers of property from one SK to another
SK/barangay/government entity/ies. The transfer shall be covered by an SK
Resolution. It shall be accomplished as follows:

4. PTR No. – shall be numbered as follows:
0000 00 000
Month
Year
5. Transfer From – name of the SK of the Barangay where the property is located.
For example, SK of Barangay San Francisco, Quezon City
6. Transfer To – name of SK/barangay/government entity where the property is to
be transferred
7. Date Acquired – acquisition date of the property and equipment
8. Property Number – number assigned by the SK Treasurer to the property and
equipment transferred
9. Description – brief description or details of the property and equipment
transferred
10. Amount – acquisition cost of the property and equipment transferred
11. Condition of the Property and Equipment – present condition of the property
and equipment transferred
12. Reason for Transfer – reason for the transfer of property
13. Approved by – signature over printed name of the SK Chairperson and date of
approval
14. Released by – signature over printed name of SK Treasurer and date of the
release
15. Received by – signature over printed name and designation of the authorized
receiving officer of the SK/Barangay/government entity/ies and the date of
receipt
B. The PTR shall be prepared in two copies to be distributed as follows:
Original – SK Treasurer
2nd copy – Recipient
225
Annex 30
BANK RECONCILIATION STATEMENT

For the month of ________________
(Date)
SK of Barangay: Bank Name:

City/Municipality: Branch:
Province: Current Account No.:
Particulars RCB Bank Explanatory Comment
Unadjusted Balances xxx xxx
Reconciling Items:
Check Issued not taken up:
In the Books (xx)
By the Bank (xx)
Check Issued Overstated:
In the Books xx
By the Bank xx
Check Issued Understated:
In the Books (xx)
By the Bank (xx)
Deposits not taken up:
In the Books xx
By the Bank xx
Deposits Overstated:
In the Books (xx)
By the Bank (xx)
Deposit Understated:
In the Books xx
By the Bank xx
Bank Debit/Credit Memos, Not taken
up in the books:
Debit Memo (xx)
Credit Memo xx
Other Reconciling Items
Adjusted Balances xx xx
Prepared and Certified Correct by: Approved by:
_________________________ __________________________
of SK Treasurer of SK Chairperson
Date Date
226
Annex 30
BANK RECONCILIATION STATEMENT

(BRS)
INSTRUCTIONS
A. This statement shall be prepared to reconcile the cash balance per RCB and per bank
statement. It shall be prepared and certified correct by the SK Treasurer, and shall be
1. Date – date covered by the statement

5. Bank Name – the bank where the account is maintained
6. Branch – the branch of the bank where the account is maintained
7. Current Account No. – the depository account number for which the BRS is
prepared
8. Particulars – unadjusted balances and the details of reconciling items per RCB and
per bank statement to arrive at the adjusted balances
9. RCB – unadjusted balance of cash per RCB, amounts of reconciling items per RCB
and the adjusted cash balance reconciled with bank
10. Bank – unadjusted balance of cash per bank statement, amounts of reconciling
items per bank and the adjusted cash balance reconciled with RCB
11. Explanatory Comment – brief comments on the reconciling items
12. Prepared and Certified Correct by: signature over printed name of the SK
Treasurer and the date of signing
13. Approved by: signature over printed name of the SK Chairperson and the date of
signing
B. The BRS shall be prepared based on the records per RCB and per bank statement
supported by paid/negotiated/returned checks, debit memos and credit memos.
C. The BRS shall be prepared in four copies to be distributed as follows:

2nd copy - SK Chairperson
3rd copy - SK Treasurer
4th copy - GOB/AGDB, if necessary
227
Annex 31
Republic of the Philippines

_____________________________________
(SK of Barangay, City/Municipality, Province)
Quarterly Statement of Receipts and Payments
For the quarter ended ______________
Receipts
Subsidy from Barangay xxx
Subsidy from Other Local Government Units xxx
Subsidy from National Government Agencies. xxx
Subsidy from Government-Owned and/or Controlled xxx
Corporations
Grants and Donations in Cash
with Specific Purpose xxx
without Specific Purpose xxx
Miscellaneous Income xxx
Other Receipts xxx
Total Receipts for the quarter xxx
Less: Payments
Maintenance and Other Operating Expenses
Travelling Expenses xxx
Training Expenses xxx
Office Supplies Expenses xxx
Semi-Expendable Property Expenses xxx
Fuel, Oil and Lubricants Expenses xxx
Accountable Forms Expenses xxx
Other Supplies and Materials Expenses xxx
Water Expenses xxx
Electricity Expenses xxx
Postage and Courier Services xxx
Telephone Expenses xxx
Internet Subscription Expenses xxx
Prizes xxx
Repairs and Maintenance-Land Improvements xxx
Repairs and Maintenance-Buildings and Other xxx
Structures
Repairs and Maintenance-Machinery xxx
Repairs and Maintenance-Office Equipment xxx
Repairs and Maintenance-Information and xxx
Communications Technology Equipment
Repairs and Maintenance-Sports Equipment xxx
Repairs and Maintenance-Transportation Equipment xxx
Repairs and Maintenance-Furniture, Fixtures and Books xxx
Repairs and Maintenance-Other Property and Equipment xxx
Fidelity Bond Premiums xxx
Advertising Expenses xxx
Rent/Lease Expenses xxx
Membership Dues and Contributions to Organizations xxx
Donation xxx
Honoraria xxx
Bank Charges xxx
Other Maintenance and Operating Expenses xxx
Total Maintenance and Other Operating Expenses xxx
228
Annex 31

_____________________________________
Quarterly Statement of Receipts and Payments
For the quarter ended ______________
Capital Outlay
Land xxx
Land Improvements xxx
Buildings xxx
Other Structures xxx
Machinery xxx
Office Equipment xxx
Information and Communications Technology Equipment xxx
Sports Equipment xxx
Transportation Equipment xxx
Furniture, Fixtures and Books xxx
Other Property and Equipment xxx
Construction in Progress-Land Improvements xxx
Construction in Progress-Buildings xxx
Construction in Progress-Other Structures xxx
Total Capital Outlay xxx
Cash Advances, Net xxx
Total Payments for the quarter xxx

Increase/(Decrease) in Cash for the quarter xxx
Add/Less: Others xxx
Total Increase/(Decrease) in Cash for the quarter xxx
Cash at beginning of quarter
Cash on Hand xxx
Cash in Bank xxx
Cash at end of quarter xxx
Breakdown of Cash at end of quarter

Cash on Hand xxx
Cash in Bank xxx

______________________ __________
SK Treasurer Date
Approved by:
______________________ ___________
SK Chairperson Date
229
Annex 31
QUARTERLY STATEMENT OF RECEIPTS AND PAYMENTS

(QSRP)
INSTRUCTIONS
A. The QSRP shall be prepared by the SK Treasurer quarterly based on the Register of
Cash Receipts and Deposits, and Other Related Financial Transactions (RCRD) and
Register of Cash in Bank and Other Related Financial Transactions (RCB). It shall be

City/Municipality and Province of the Barangay
2. For the quarter ended – date for which the statement is being prepared
3. Receipts – account and the corresponding amount based on the “Totals for the
quarter” of the “Breakdown of Receipts/Direct Deposit” of the RCRD
4. Payments – account and the corresponding amount based on the “Totals for the
quarter” of the “Breakdown of Withdrawals/Payments” of the RCB
5. Increase/(Decrease) in Cash for the quarter – total receipts for the quarter minus
total payments for the quarter
6. Others – amount of other adjustments involving cash such as loss of cash suffered
by SK due to theft/fortuitous events/calamities/civil unrest and events of same
nature
7. Total Increase/(Decrease) in Cash for the quarter – the increase/decrease in cash
for the quarter plus or minus others, if any
8. Cash at beginning of quarter:
- Cash on Hand – balance of cash on hand at the beginning of the quarter based
on RCRD
- Cash in Bank – balance of cash in bank at the beginning of the quarter based on
RCB
9. Cash at end of quarter – total increase/(decrease) in cash for the quarter plus cash
at beginning of quarter (cash on hand and cash in bank)
10. Breakdown of Cash at end of quarter:
- Cash on Hand – balance of cash on hand at the end of the quarter based on
RCRD
- Cash in Bank – balance of cash in bank at the end of the quarter based on RCB
B. The details of the cash advance shall be presented in the Notes to Financial Statements.
C. The SRP shall be prepared and certified correct by the SK Treasurer and duly approved
by the SK Chairperson and the date of signing shall be indicated.
D. This statement shall be prepared in two copies to be distributed as follows:

Photocopies of the - SK and Sangguniang Barangay
Original
230
Annex 32
REPORT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS

For the quarter ended _________, 20____
SK of Barangay: _____________________ City/Municipality: ________________ RAAF No. _______

SK Treasurer: _______________________ Province: _______________________
Beginning Balance Receipt Issued Ending Balance

Inclusive Inclusive Inclusive Inclusive
Name of Form
Qty. Serial Nos. Qty. Serial Nos. Qty. Serial Nos. Qty. Serial Nos.
From To From To From To From To
A. With Money Value
Cash Tickets
B. Without Money Value

Official Receipts
Checks
CERTIFICATION:
I hereby certify that the foregoing is a true statement of all accountable forms received, issued and
transferred by me during the above-stated period and the correctness of the beginning balances.
__________________________________ __________________
SK Treasurer Date
231
Annex 32
REPORT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS

(RAAF)
INSTRUCTIONS
A. This report shall be used to report all requisitions and issuances of accountable forms by
the SK Treasurer to be accomplished as follows:
1. For the Quarter Ended ______, 20__ – the quarter covered by the report
6. RAAF No. – the RAAF shall be numbered as follows:
0000 - 00 - 000

Month
Year
7. Name of Form – name of accountable forms under the custody of SK Treasurer
8. Beginning Balance – quantity and inclusive serial nos. of accountable forms
available at the beginning of the month
9. Receipt – quantity and inclusive serial nos. of accountable forms received during the
month
10. Issued – quantity and inclusive serial nos. of accountable forms issued during the
month
11. Ending Balance – quantity of accountable forms and inclusive serial nos. still in the
custody of SK Treasurer at the end of the month.
12. Certification – shall be certified by the SK Treasurer and the date of certification shall
be indicated
B. The RAAF shall be prepared in three copies to be distributed as follows:

2nd copy - SK Chairperson
rd
3 copy - SK Treasurer
232
Annex 33
Province __________________
SUMMARY OF BUDGET, COMMITMENTS, PAYMENTS AND BALANCES

As at _____________, 20__
Balance, Balance, Unpaid

Particulars Budget Commitments Payments Available Budget Commitments
(a) (b) (c) (a-b) (b-c)
I. Current Year Budget
1. Priority Program
1.a. PPA
MOOE
CO
2. Priority Program
2.a PPA
MOOE
CO
Sub-total
II. Continuing Budget

1. Priority Program
1.a. PPA
CO
2. Priority Program
2.a PPA
CO
Sub-total
Grand Total
__________________________________________ ________________ __________________________________________ ______________

Signature over Printed Name of Date Signature over Printed Name of Date
Budget Monitoring Officer SK Chairperson
233
Annex 33
SUMMARY OF BUDGET, COMMITMENTS, PAYMENTS AND BALANCES

(SCBCPB)
INSTRUCTIONS
A. The SBCPB shall be prepared by the Budget Monitoring Officer quarterly based on the
Registry of Budget, Commitments, Payments and Balances. It shall be accomplished as
follows:

4. As at – date for which the SBCPB is being prepared
5. Particulars – details or information of the amounts presented (Current Year
Budget/Continuing Budget, Priority Program/PPA and MOOE/CO
6. Budget – amount of Annual or Supplemental Budget based on SK Resolution
7. Commitments – refer to the amounts committed to be paid for any lawful
expenditure made by the accountable SK official for and in behalf of the SK
8. Payments – the actual amount paid based on the check issued
B. The quarterly totals/balances of the applicable RBCPBs shall be indicated in the

appropriate fields of the SBCPB. Sub-total and grand total shall be computed every
reporting period.
C. The SBCPB shall be prepared and certified correct by the Budget Monitoring Officer
and duly approved by the SK Chairperson and the date of signing shall be indicated.
D. The SBCPB shall be prepared in two copies to be distributed as follows:

2nd copy - Budget Monitoring Officer
Original
E. The SK shall evaluate the status of their budget based on the SBCPB.
234
Annex 34
Province __________________
SUMMARY OF SPECIFIC PURPOSE FUND, COMMITMENTS, PAYMENTS AND BALANCES

As at _____________, 20__
Balance, Available Balance, Unpaid

Particulars Specific Purpose Fund Commitments Payments Specific Purpose Fund Commitments
(a) (b) (c) (a-b) (b-c)
1. Priority Program
1.a. PPA
MOOE
CO
2. Priority Program
2.a PPA
MOOE
CO
3. Priority Program
3.a PPA
MOOE
CO
Grand Total
__________________________________________ ___________________ ____________________________________ __________________

Signature over Printed Name of Date Signature over Printed Name of Date
Budget Monitoring Officer SK Chairperson
235
Annex 34
SUMMARY OF SPECIFIC PURPOSE FUND, COMMITMENTS,

(SSPFCPB)
INSTRUCTIONS
A. The SSPFCPB shall be prepared by the Budget Monitoring Officer quarterly based on
the Registry of Specific Purpose Fund, Commitments, Payments and Balances. It shall
be accomplished as follows:

4. As at – date for which the SFCPB is being prepared
5. Particulars – details or information of the amounts presented (Priority
Program/PPA and MOOE/CO
6. Specific Purpose Fund – refer to the amounts of funds received with specific
purpose based on SK Resolution
7. Commitments – refer to the amounts committed to be paid for any lawful
expenditure made by the accountable SK official for and in behalf of the SK
8. Payments – the actual amount paid based on the check issued
9. Balance, Specific Purpose Fund – total specific purpose fund less commitments
B. The quarterly totals/balances of the applicable RSPFCPBs shall be indicated in the

appropriate fields of the SSPFCPB. Grand total shall be computed every reporting
period.
C. The SSPFCPB shall be prepared and certified correct by the Budget Monitoring Officer
D. The SSPFCPB shall be prepared in two copies to be distributed as follows:

Original
E. The SK shall evaluate the status of their specific purpose fund based on the SSPFCPB.
236
Annex 35
REPORT ON INVENTORY OF PURCHASED SUPPLIES AND MATERIALS

As at ______________, 20___
SK of Barangay: _______________________
City/Municipality: ______________________
Province: _____________________________
For which _______________________________, _______________ is accountable, having assumed such accountability on _______________.
(Name of Accountable SK Official) (Official Designation) (Date of Assumption)
Balance On Hand Shortage/Overage

Unit of Per Stock Card Per Count Remarks
Article Item Description Stock No. Measurement Unit Cost (Quantity) (Quantity) Quantity Value
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
_____________________________ _____________________________ _____________________________ __________________________

Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name
Member, Inventory Committee Member, Inventory Committee Head, Inventory Committee SK Chairperson
Date: _________________ Date: _________________ Date: _____________ Date: ______________
237
Annex 35
REPORT ON INVENTORY OF PURCHASED

(RIPSM)
INSTRUCTIONS
A. This report shall be prepared semi-annually in the conduct of physical count of

purchased supplies and materials in the custody of SK Treasurer, including unrecorded
items and/or found at station. It shows the balances of supplies and materials per Stock
Card (SC), per count and the shortage/overage, if any. It shall be prepared and certified
correct by the Inventory Committee and approved by the SK Chairperson. It shall be
1. As at – date the count was conducted

5. Name of Accountable SK Official – name of the accountable SK official or Supply
and Property Officer
6. Official Designation – official designation of the accountable SK official
7. Date of Assumption – first day of assumption of the duties and responsibilities as
accountable SK official
10. Stock No. – number assigned by the SK Treasurer to the item
11. Unit of Measurement – unit of measurement of the item e.g., box, bottle, piece,
etc.
12. Unit Cost – cost per unit of the item
13. Balance per Stock Card – the balance appearing in the SC
14. On Hand per Count – quantity of items or articles per physical count
15. Shortage/Overage – excess of the quantity and total value of items or articles per
SC over that of the physical count (Shortage) or vice versa (Overage)
16. Remarks – whereabouts, conditions and other relevant information on the
purchased supplies and materials noted during the physical count
17. Prepared and Certified Correct by – signature over printed name of three members
designated as the committee head and members and the date of signing
signing
B. The first six columns shall be filled out by the SK Treasurer while the last four columns
shall be filled out by the Inventory Committee.
C. The RIPSM shall be prepared in three copies to be distributed as follows:

2nd copy – Inventory Committee
Photocopies of – SK
the original
238
Annex 36
REPORT ON INVENTORY OF DONATED SUPPLIES AND MATERIALS

As at ______________, 20___
SK of Barangay: _______________________
Province: _____________________________
For which _______________________________, _______________ is accountable, having assumed such accountability on _______________.

Unit of Per RDSM Per Count
Article Item Description Stock No. Measurement Unit Cost (Quantity) (Quantity) Quantity Value Remarks
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
_____________________________ _____________________________ _____________________________ __________________________

239
Annex 36
REPORT ON INVENTORY OF DONATED

(RIDSM)
INSTRUCTIONS
A. This report shall be prepared semi-annually in the conduct of physical count of donated
supplies and materials in the custody of SK Treasurer, including those unrecorded
and/or found at station. It shows the balance of supplies and materials per Registry of
Donated Supplies and Materials (RDSM) and per count and the shortage/overage, if
any. It shall be prepared and certified correct by the Inventory Committee and
approved by the SK Chairperson. It shall be accomplished as follows:

10. Stock No. – number assigned by the SK Treasurer to the item
11. Unit of Measurement – unit of measurement of the item e.g., box, bottle, piece,
etc.
12. Unit Cost – cost per unit of the item, if available; or indicate “Not Available” if
cost cannot be determined
13. Balance per RDSM – the balance appearing in the RDSM
RDSM over that of the physical count (Shortage) or vice versa (Overage)
16. Remarks – whereabouts, conditions and other relevant information on the donated
supplies and materials noted during the physical count
signing
C. The RIDSM shall be prepared in three copies to be distributed as follows:

2nd copy – Inventory Committee
Photocopies of the Original – SK
240
Annex 37

_____________________________________
Annual Statement of Receipts and Payments
For the year ended ____________
Receipts
Subsidy from Barangay xxx
Subsidy from Other Local Government Units xxx
Subsidy from National Government Agencies xxx
Subsidy from Government-Owned and/or Controlled xxx
Corporations
Grants and Donations in Cash
with Specific Purpose xxx
without Specific Purpose xxx
Miscellaneous Income xxx
Other Receipts xxx
Total Receipts for the year xxx
Less: Payments
Maintenance and Other Operating Expenses
Travelling Expenses xxx
Training Expenses xxx
Office Supplies Expenses xxx
Semi-Expendable Property Expenses xxx
Fuel, Oil and Lubricants Expenses xxx
Accountable Forms Expenses xxx
Other Supplies and Materials Expenses xxx
Water Expenses xxx
Electricity Expenses xxx
Postage and Courier Services xxx
Telephone Expenses xxx
Internet Subscription Expenses xxx
Prizes xxx
Repairs and Maintenance-Land Improvements xxx
Repairs and Maintenance-Buildings and Other xxx
Structures
Repairs and Maintenance-Machinery xxx
Repairs and Maintenance-Office Equipment xxx
Repairs and Maintenance-Information and xxx
Communications Technology Equipment
Repairs and Maintenance-Sports Equipment xxx
Repairs and Maintenance-Transportation Equipment xxx
Repairs and Maintenance-Furniture, Fixtures and Books xxx
Repairs and Maintenance-Other Property and Equipment xxx
Fidelity Bond Premiums xxx
Advertising Expenses xxx
Rent/Lease Expenses xxx
Membership Dues and Contributions to Organizations xxx
Donation xxx
Honoraria xxx
Bank Charges xxx
Performance Bond xxx
Bidders Bond xxx
Other Maintenance and Operating Expenses xxx
Total Maintenance and Other Operating Expenses xxx
241
Annex 37

_____________________________________
Annual Statement of Receipts and Payments
For the year ended _____________
Capital Outlay
Land xxx
Land Improvements xxx
Buildings xxx
Other Structures xxx
Machinery xxx
Office Equipment xxx
Information and Communications Technology Equipment xxx
Sports Equipment xxx
Transportation Equipment xxx
Furniture, Fixtures and Books xxx
Other Property and Equipment xxx
Construction in Progress-Land Improvements xxx
Construction in Progress-Buildings xxx
Construction in Progress-Other Structures xxx
Total Capital Outlay xxx
Cash Advances, Net xxx
Total Payments for the year xxx

Increase/(Decrease) in Cash for the year xxx
Add/Less: Others xxx
Total Increase/(Decrease) in Cash for the year xxx
Cash at beginning of year
Cash on Hand xxx
Cash in Bank xxx
Cash at end of year xxx
Breakdown of Cash at end of year

Cash on Hand xxx
Cash in Bank xxx
Prepared and certified correct by:

______________________ __________
SK Treasurer Date
Approved by:
______________________ ___________
SK Chairperson Date
242
Annex 37
ANNUAL STATEMENT OF RECEIPTS AND PAYMENTS

(ASRP)
INSTRUCTIONS
A. The ASRP shall be prepared annually by the SK Treasurer based on the consolidated
amounts of Quarterly Statement of Receipts and Payments (QSRP). It shall be

City/Municipality and Province of the Barangay
2. For the year ended – date for which the statement is being prepared
3. Receipts – account and the corresponding amount based on the consolidated data in
the “Receipts” portion of the QSRP
4. Payments – account and the corresponding amount based on the consolidated data
in the “Payments” portion of the QSRP
5. Increase/(Decrease) in Cash for the year – total receipts for the year minus total
payments for the year
6. Others – amount of other adjustments involving cash such as loss of cash suffered
by SK due to theft/fortuitous events/calamities/civil unrest and events of same
nature
7. Total Increase/(Decrease) in Cash for the year – the increase/decrease in cash for
the quarter plus or minus others, if any
8. Cash at beginning of year:
- Cash on Hand – balance of cash on hand at the beginning of the year based on
RCRD
- Cash in Bank – balance of cash in bank at the beginning of the year based on
RCB
9. Cash at end of quarter – total increase/(decrease) in cash for the year plus cash at
beginning of year (cash on hand and cash in bank)
10. Breakdown of Cash at end of quarter:
- Cash on Hand – balance of cash on hand at the end of the year based on RCRD
- Cash in Bank – balance of cash in bank at the end of the year based on RCB
B. The details of the cash advance shall be presented in the Notes to Financial Statements.
C. The SRP shall be prepared and certified correct by the SK Treasurer and duly approved
by the SK Chairperson and the date of signing shall be indicated.
D. This statement shall be prepared in two copies to be distributed as follows:

Original
243
Annex 38
Province __________________
STATEMENT OF COMPARISON OF BUDGET AND ACTUAL AMOUNT

For the year ended ______________
Difference
Particulars Actual Amounts Final Budget Original Budget Actual and Final Budget
(a) (b) (a-b)
CASH INFLOWS
Subsidy from barangay (10% of the general fund)
Receipts from other sources of revenue:
Grants and Donations in Cash w/out Specific Purpose
Miscellaneous Income
Other Receipts
Total Receipts
CASH OUTFLOWS
General administration program
Equitable access to quality education
Environmental protection
Climate change adaptation
Disaster risk reduction and resiliency
Youth employment and livelihood
Health and anti-drug abuse
Gender sensitivity
Sports development
Capability building
Total Payments
NET CASH FLOWS
______________________________________________ ____________ ___________________________________ ____________

Signature over Printed Name of Budget Monitoring Officer Date Signature over Printed Name of SK Chairperson Date
244
Annex 38
STATEMENT OF COMPARISON OF BUDGET AND ACTUAL AMOUNT

(SCBAA)
INSTRUCTIONS
A. The SCBAA shall be prepared by the Budget Monitoring Officer annually based on the
Statement of Receipt and Payments, and Summary of Budget, Commitments, Payments
and Balances. It shall be accomplished as follows:

4. For the year ended ____ – date for which the statement is being prepared
5. Actual Amounts
 Cash Inflow – based on the Statement of Receipts and Payments except funds
received with specific purpose
 Cash Outflow – based on the Summary of Budget, Commitments, Payments
and Balances
6. Final Budget
 Cash Inflow – based on the Original and Supplemental Budget per SK
Resolution
 Cash Outflow – based on the Summary of Budget, Commitments, Payments
and Balances
7. Original Budget – based on the approved annual budget
8. Difference, Actual and Final Budget – difference between actual amounts and
final budget
B. The SCBAA shall be prepared and certified correct by the Budget Monitoring Officer
C. The SCBAA shall be prepared in two copies to be distributed as follows:

Original
245
Annex 39
REPORT ON INVENTORY OF PURCHASED PROPERTY AND EQUIPMENT

As at ________________, 20___
SK of Barangay: _______________________
Province: _____________________________
For which ________________________________, _________________ is accountable, having assumed such accountability on ______________.

Property Unit of Unit Per PEC Per Count
Article Item Description No. Measurement Cost (Quantity) (Quantity) Quantity Value Remarks
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

_____________________________ _____________________________ _____________________________ __________________________
246
Annex 39
REPORT ON INVENTORY OF PURCHASED

PROPERTY AND EQUIPMENT
(RIPPE)
INSTRUCTIONS
A. This report shall be prepared annually in the conduct of physical count of purchased
property and equipment. It provides information on the physical existence and condition
of the property and equipment, including those unrecorded and/or found at station. It
shows the balance of property and equipment per Property and Equipment Card (PEC)
and per count and the shortage/overage, if any. It shall be prepared and certified correct
by the Inventory Committee and approved by the SK Chairperson. It shall be
8. Article – type or classification of property and equipment (e.g., laptop/desktop
computer, printer, filing cabinet, motorcycle, etc.)
10. Property No. – number assigned by the SK Treasurer to the item
11. Unit of Measurement – unit of measurement of the item e.g., set, piece, etc.
12. Unit Cost – cost per unit of the item
13. Balance per PEC – balance (received less transferred, lost and disposed) appearing
in the PEC
PEC over that of the physical count (Shortage) or vice versa (Overage)
16. Remarks – whereabouts, conditions and other relevant information on the property
and equipment noted during the physical count
signing
C. The RIPPE shall be prepared in three copies to be distributed as follows:
3rd copy – Inventory Committee
247
Annex 40
REPORT ON INVENTORY OF DONATED PROPERTY AND EQUIPMENT

As at ________________, 20___
SK of Barangay: _______________________
Province: _____________________________
For which ________________________________, _________________ is accountable, having assumed such accountability on ______________.

Property Unit of Unit
Per RDPE Per Count Remarks
Article Item Description No. Measurement Cost Quantity Value
(Quantity) (Quantity)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

_____________________________ _____________________________ _____________________________ __________________________
248
Annex 40
REPORT ON INVENTORY OF DONATED

PROPERTY AND EQUIPMENT
(RIDPE)
INSTRUCTIONS
A. This report shall be prepared annually in the conduct of physical count of donated
property and equipment. It provides information on the physical existence and
condition of the property and equipment, including those unrecorded and/or found at
station. It shows the balance of property and equipment per Registry of Donated
Property and Equipment (RDPE) and per count and the shortage/overage, if any. It shall
be prepared and certified correct by the Inventory Committee and approved by the SK
Chairperson. It shall be accomplished as follows:
5. Name of Accountable SK Official – name of the accountable SK official/Supply
8. Article – type or classification of property and equipment (e.g., laptop/desktop
computer, printer, filing cabinet, motorcycle, etc.)
10. Property No. – number assigned by the SK Treasurer to the item
11. Unit of Measurement – unit of measurement of the item e.g., set, piece, etc.
12. Unit Cost – cost per unit of the item, if available; or indicate “Not Available” if
cost cannot be determined
13. Balance per RDPE – the balance (received less the transferred, lost and disposed)
appearing in the RDPE
RDPE over that of the physical count (Shortage) or vice versa (Overage)
16. Remarks – whereabouts, conditions and other relevant information on the property
and equipment noted during the physical count
approval
C. The RIDPE shall be prepared in three copies to be distributed as follows:
3rd copy – Inventory Committee
249
Annex 41

Notes to Financial Statements
For the period ended _______________, 20___
Notes to the Financial Statements
1. Accounting Policies:
Basis of preparation
The financial statements of the SK of Barangay ___________________ have been prepared in cash basis
substantially aligned to Cash Basis IPSAS, “Financial Reporting under the Cash Basis of Accounting.”
The accounting policies have been applied consistently throughout the period .
Reporting Agency/Entity
The financial statements are for SK of Barangay _____________________, located in geographical location. It’s
office is located at official address in the barangay.
The financial statements encompass the SK of Barangay _______________________________ as specified in

Republic Act No. 10742, otherwise known as the “Sangguniang Kabataan Reform Act of 2015.” The SK is
composed of a chairperson and seven (7) members were be elected by the KK on ________________.
The SK chairperson with the concurrence of the majority of all the SK members, appointed from among the
members of the KK, the secretary and the treasurer
The principal activity of the SK of Barangay ___________________ is to provide services to its constituents.
The SK of Barangay _________________________ controls its own bank account. The approved budget and
other cash receipts are deposited into its bank accounts.
Payments by other government agencies/entities
The SK of Barangay _______________________________ benefits from payments made by Barangay

__________________________ pertaining to honoraria of the SK Chairperson ________________ amounting to
____________.
Reporting currency
The reporting currency is Philippine peso.
2. Cash
Cash comprises cash on hand and demand deposits and cash equivalents. Demand deposits comprise balances
with banks.
250
Annex 41
The approved budgets of the SK of Barangay ________________________________ are deposited in the

(Agency’s/Entity’s bank) ___________________ under Current Account No. ________ and are controlled by
the agency/entity.
Receipts from donations are deposited in SK of Barangay _____________________ bank account.
3. Authorization Date
The financial statements were authorized for issue on __________________. (Note: date the SK Chairperson
signed on the approval portion of the FS)
4. Property and equipment
The SK of Barangay ______________________________ maintains records of the following property and

equipment amounting to _______________as of December 31, _______stated at historical cost:
Account Amount
5. Liabilities
The SK of Barangay _______________________ have outstanding payables amounting to ____________.

Details are as follows:
Creditor Nature Amount Due date

Supplier ABC Goods delivered
Agency X Seminar fees
6. Receipt of Goods and Services (sample narrative only)

During 20__, a severe earthquake occurred in _____ (region) inflicting serious damage to government property
and private property, and significant loss of life. Government agencies and other private institutions donated
goods and equipment to assist in locating and rescuing individuals trapped in the rubble. In addition, specialized
medical teams trained in trauma treatment together with medical equipment, were flown into the ____ (region).
Temporary shelter and food were also supplied.
The value of goods and services received has been estimated at Php_________. The value of the emergency
assistance provided has been determined based on cost estimates provided by these agencies/institutions
involved because local prices for equivalent goods or services were not available.
_________ tons of rice was received as food aid during the year. It has been valued at Php __________ currency
units which represents the wholesale price of similar rice in domestic wholesale markets.
Goods and services received during the year were not recorded in the Statement of Cash Receipts and Payments,
which reflects only cash received (directly or indirectly) or paid by the SK. Goods and services-in-kind were
received as part of the emergency assistance and are reflected in this note.
251

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Annex 1

REGISTRY OF BUDGET, COMMITMENTS, PAYMENTS AND BALANCES

Total Budget carried forward

Total Commitments carried forward

Total Payments carried forward

Balance, Available Budget (a-b)

REGISTRY OF BUDGET, COMMITMENTS, PAYMENTS AND BALANCES

A. The RBCPB-MOOE shall be maintained daily by the Budget Monitoring Officer by

1. SK of Barangay – name of the barangay SK

Total Budget carried forward

Total Commitments carried forward

Total Payments carried forward

Balance, Available Budget (a-b)

REGISTRY OF BUDGET, COMMITMENTS, PAYMENTS AND BALANCES

A. The RBCPB-MOOE shall be maintained daily by the Budget Monitoring Officer by

1. SK of Barangay – name of the barangay SK

REGISTRY OF BUDGET, COMMITMENTS, PAYMENTS AND BALANCES

Total Budget carried forward

Total Commitments carried forward

Total Payments carried forward

Balance, Available Budget (a-b)

REGISTRY OF BUDGET, COMMITMENTS, PAYMENTS AND BALANCES

A. The RBCPB-CO shall be maintained daily by the Budget Monitoring Officer by

1. SK of Barangay – name of the barangay SK

Total Budget carried forward

Total Commitments carried forward

Total Payments carried forward

Balance, Available Budget (a-b)

REGISTRY OF BUDGET, COMMITMENTS, PAYMENTS AND BALANCES

A. The RBCPB-CO shall be maintained daily by the Budget Monitoring Officer by

1. SK of Barangay – name of the barangay SK

C. A new sheet shall be used at the beginning of each quarter.

REGISTRY OF SPECIFIC PURPOSE FUND, COMMITMENTS, PAYMENTS AND BALANCES

Total Specific Purpose Fund carried forward

Total Commitments carried forward

Total Payments carried forward

Balance, Available Specific Purpose Fund (a-b)

REGISTRY OF SPECIFIC PURPOSE FUND, COMMITMENTS,

A. The RSPFCPB-MOOE shall be maintained daily by the Budget Monitoring Officer by

1. SK of Barangay – name of the barangay SK

REGISTRY OF SPECIFIC PURPOSE FUND, COMMITMENTS, PAYMENTS AND BALANCES

Total Specific Purpose Fund carried forward

Total Commitments carried forward

Total Payments carried forward

Balance, Available Specific Purpose Fund (a-b)

REGISTRY OF SPECIFIC PURPOSE FUND, COMMITMENTS,

1. SK of Barangay – name of the barangay SK

REGISTER OF CASH RECEIPTS, DEPOSITS AND OTHER RELATED FINANCIAL TRANSACTIONS

Totals for the

REGISTER OF CASH RECEIPTS, DEPOSITS AND OTHER RELATED

1. SK of Barangay – name of the Barangay SK

B. A new sheet shall be used at the beginning of each quarter.

REGISTER OF CASH IN BANK AND OTHER RELATED FINANCIAL TRANSACTIONS

Totals for the

REGISTER OF CASH IN BANK AND OTHER RELATED FINANCIAL

A. Certified as to availability B. Certified as to availability C. Certified as to necessity,

_______________________ _________________________ ________________________

A. This form shall be used by the SK Treasurer to pay individuals/entities/creditors for

1. SK of Barangay – name of the barangay SK

___________ _ ____________

AMOUNT OF CASH ADVANCE PER DV NO._DTD._

AMOUNT REFUNDED PER O.R. NO.DTD.__

____________ _ _____________

_________ _ ___________

Date Inspected: _____ Date Received:_