Disbursement Voucher Form
1
Annex B Republic of the Philippines DEPARTMENT OF EDUCATION DepED Complex, Meralco Avenue, Pasig City DISBURSEMENT VOUCHER No. MDS Check Commercial Check ADA Others Payee TIN/Employee No. OR/BUR No. Address Responsibility Center Office/Unit/Project Code EXPLANATION AMOUNT A. Certified B. Approved for Payment Cash available Subject to Authority to Debit Account (when applicable) Supporting documents complete Signature Signature Position Position Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative Agency Head/Authorized Representative Date Date C. Received Payment JEV No. Date Bank Name Signature Date Printed Name Date Official Receipt/Other Documents Mode of Payment Printed Name Printed Name Representative Check/ ADA No.
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Transcript of Disbursement Voucher Form
Annex B
Republic of the Philippines
DEPARTMENT OF EDUCATIONDepED Complex, Meralco Avenue, Pasig City
DISBURSEMENT VOUCHERNo.
MDS Check Commercial Check ADA Others
PayeeTIN/Employee No. OR/BUR No.
Address
Responsibility CenterOffice/Unit/Project Code
EXPLANATION AMOUNT
A. Certified B. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete
Signature Signature
Position PositionHead, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
C. Received Payment JEV No.
Date Bank Name
Signature Date Printed Name Date
Official Receipt/Other Documents
Mode of Payment
Printed Name
Printed Name
Check/ ADA No.
