LIQUIDATION REPORT No.

Dated

SOUTHERN LEYTE STATE UNIVERSITY - TOMAS OPPUS

Responsibility Center
Agency Name
Code:

PARTICULARS AMOUNT

To liquidation of cash advance for Cebu City Travel last Nov. 22 - 23, 2013 as per
supporting papers hereto attached . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,125.00

TOTAL AMOUNT SPENT 1,125.00

AMOUNT OF CASH ADVANCE PER DV NO. DTD 1,470.00
AMOUNT REFUNDED PER OR NO. DTD (345.00)
AMOUNT TO BE REIMBURSED
A. Certified: Correctness of the B. Certified : Purpose of travel/cash C. Certified : Supporting documents
above data advance duly accomplished complete and proper

MAURO T. TANTOY, JR. ENGR. JUMAR F. PEREZ LESTER GLENN G. TABADA

Claimant Immediate Supervisor Head, Accounting Unit JEV NO.