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Department of Environment and Natural Resources: Annex A

This document is a certification form from the Department of Environment and Natural Resources for expenses not requiring receipts. It requires the employee's name and number, office, itemized particulars of expenses without receipts, the total amount, purpose of expenses, and signatures of the employee and immediate supervisor certifying the accuracy of the expenses.

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0% found this document useful (0 votes)
76 views1 page

Department of Environment and Natural Resources: Annex A

This document is a certification form from the Department of Environment and Natural Resources for expenses not requiring receipts. It requires the employee's name and number, office, itemized particulars of expenses without receipts, the total amount, purpose of expenses, and signatures of the employee and immediate supervisor certifying the accuracy of the expenses.

Uploaded by

nitz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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ANNEX A

Republic of the Philippines


Department of Environment and Natural Resources
Visayas Avenue, Diliman, 1106 Quezon City
(632) 929-6626 to 29; 929-6252; 929-6633 to 35; 929-7041 to 43
E-mail: [email protected]; Website: www.denr.gov.ph

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS


Pursuant to COA Circular No. 2017-001 dated June 19, 2017
Name of Employe: Employee No.:
Office/Division:
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 statement is punishable by law.

Certified Correct: Noted by:


Signature
Printed Name
Employee Immediate Supervisor
Date: Date:

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