Republic of the Philippines

DEPARTMENT OF EDUCATION
DIVISION OF SILAY CITY
City of Silay

DISBURSEMENT VOUCHER NO.:

Mode of
Payment MDS Check Commercial Check ADA Others
TIN/Employee No. OR/BUR No.
Payee
Responsibility Center
Address Office/Unit/Project Code

EXPLANATION AMOUNT

###

###
###

TOTAL P -
A. Certified B Approved for Payment

Cash Available

Subject to Authority to Debit Account (when applicable)

Supporting documents complete

Signature Signature
Printed Printed
Name Name

Position Position

Date Date

C. Received Payment JEV no.

Check/ Date Bank Name
ADA No.
Date Printed Name
Signature 0 Date:
Official Receipt/Other Documents
 Republic of the Philippines
DEPARTMENT OF EDUCATION
DIVISION OF SILAY CITY
City of Silay

DISBURSEMENT VOUCHER NO.:

Mode of
Payment MDS Check Commercial Check ADA Others
X TIN/Employee No. OR/BUR No.
Payee X
Responsibility Center
Address Office/Unit/Project Code

EXPLANATION AMOUNT

###

###
###

TOTAL P -
A. Certified B Approved for Payment
Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete

Signature Signature
Printed Printed
Name Name

Position Position

Date Date
C. Received Payment JEV no.
Check/ Date Bank Name
ADA No.
Date Printed Name
Signature 0 Date:
Official Receipt/Other Documents