Annex A

Republic of the Philippines

Province of Bohol
MUNICIPAL GOVERNMENT OF LOBOC
No.
OBLIGATION REQUEST
Payee LUISITO DIGAL ET AL

Office LOBOC BOHOL

Address LOBOC BOHOL

Responsibility Account
Center Particulars FPP Code Amount

RATA - SB FOR THE MONTH OF MAY 2012 100,500.00

Total
A Certified: B Certified:
1. Charges to appropriation/allotment necessary,lawful & under my direct supervision.
Existence of available appropriation
2. Supporting documents valid, proper and legal

Signature Signature
Printed Date Printed Date
LEON A. CALIPUSAN ANTONIO ACUÑA
Name 5/2/2012 Name 5/2/2012
Mun. Mayor Municipal Budget Officer
Position Position
Head of Requesting Office/Authorized Representative Head of Budget Unit/Representative

Annex A
Republic of the Philippines
Province of Bohol
MUNICIPAL GOVERNMENT OF LOBOC
No.
OBLIGATION REQUEST
Payee LUISITO DIGAL ET AL

Office LOBOC BOHOL

Address LOBOC BOHOL

Responsibility Account
Center Particulars FPP Code Amount

RATA - SB FOR THE MONTH OF MAY 2012 100,500.00

Total
A Certified: B Certified:
1. Charges to appropriation/allotment necessary,lawful & under my direct supervision.
Existence of available appropriation
2. Supporting documents valid, proper and legal
Signature Signature
Printed Date Printed Date
LEON A. CALIPUSAN ANTONIO ACUÑA
Name 5/2/2012 Name 5/2/2012
Mun. Mayor Municipal Budget Officer
Position Position
Head of Requesting Office/Authorized Representative Head of Budget Unit/Representative
 Annex B
Republic of the Philippines
Province of Bohol
MUNICIPAL GOVERNMENT OF LOBOC
No.
DISBURSEMENT VOUCHER
Mode of
( ) Check ( ) Cash ( ) Others
Payment
TIN/Employee No. Obligation Request No.
Payee Josephine Dahunan, et al.
Responsibility Center
Address LOBOC BOHOL Office/Unit/Project Code

EXPLANATION AMOUNT
P 7,500.00
COMMUNICATION EXPENSE FOR OCTOBER 2011

Net Payable
A Certified: B Certified:
1. Allotment obligated as indicated above
Funds are available.
2. Supporting documents complete
Signature Signature
Printed Date Printed Date
LYNN M. BASAÑES ILUMINADA H. CABANSAY
Name 10/18/2011 Name 10/18/2011
MUNICIPAL ACCOUNTANT Municipal Treasurer
Position Position
Head Accounting Unit/Representative Treasurer/Authorized Representative
C Approved for Payment D Received Payment
Check No. Bank Name Date
Signature
Printed Date Signature Date
LEON A. CALIPUSAN
Name 10/18/2011 Printed Name Josephine Dahunan, et al. 10/18/2011
MUNICIPAL MAYOR OR and other Documents JEV No Date
Position
Agency Head/Authorized Representative

Annex B
Republic of the Philippines
Province of Bohol
MUNICIPAL GOVERNMENT OF LOBOC
No.
DISBURSEMENT VOUCHER
Mode of
( ) Check ( ) Cash ( ) Others
Payment
TIN/Employee No. Obligation Request No.
Payee Josephine Dahunan, et al.
Responsibility Center
Address LOBOC BOHOL Office/Unit/Project Code

EXPLANATION AMOUNT
P 7,500.00
COMMUNICATION EXPENSE FOR OCTOBER 2011

Net Payable 7,500.00

A Certified: B Certified:
1. Allotment obligated as indicated above
Funds are available.
2. Supporting documents complete
Signature Signature
Printed Date Printed Date
LYNN M. BASAÑES ILUMINADA H. CABANSAY
Name 10/18/2011 Name 10/18/2011
MUNICIPAL ACCOUNTANT Municipal Treasurer
Position Position
Head Accounting Unit/Representative Treasurer/Authorized Representative
C Approved for Payment D Received Payment
Check No. Bank Name Date
Signature
Printed Date Signature Date
LEON A. CALIPUSAN
Name 10/18/2011 Printed Name Josephine Dahunan, et al. 10/18/2011
MUNICIPAL MAYOR OR and other Documents JEV No Date
Position
Agency Head/Authorized Representative
 Payroll - Communication Expense
Period Covered: January-23

PERIOD DEDUCTIONS Net Signature

Gross
NAME DESIGNATION OF SERVICE Wiholding GSIS PREMIUM MEDICARE EC Amount No. of
Pay
Tax PS GS PS GS Due Payee

Name of Payee

1 Dioscora A. Sumampong HRMO V January-23 2,000.00 2,000.00 1

GRAND TOTALS 2,000.00 2,000.00

(5) I HEREBY CERTIFY on my official oath that I have paid in cash to each official
(1) I HEREBY CERTIFY on my official oath that the above PAYROLL is correct, and that the services and employee whose name appears on the above roll the amount set opposite his
name, he having signed or marked his name, in my presence and at the time
stated above have been duly rendered. Payment for such services is also hereby approved from the that payment was made to him in acknowledgment of receipt of the money paid him.
appropriation indicated.
LYNN M. BASANES ________________, 2023 _____________________
` Municipal Treasurer Date Disbursing Officer
(2) APPROVED for payment subject to pre-audit:
(6) I HEREBY CERTIFY on my official oath that each employee whose
________________________,20__________________ Treasurer
name appears on the above roll have been paid in cash or in check, and in no
(3) Preaudited and approved for payment in the amount of other mode, the amount opposite his name. The total of the payments made
_______________________________________ (P _________) only. by means of this payroll amounts to Two Thousand Pesos Only_(P 2,000.00)
___________________________ ________________, 2023 pesos only.
Provincial Auditor Date (4) APPROVED:

HON. RAYMOND G. JALA

Municipal Mayor
 Payroll - Communication Expense
Period Covered: Nov.2023

DEDUCTIONS Net
PERIOD OF Gross
NAME OF PAYEE DESIGNATION Wiholding GSIS PREMIUMMEDICARE EC Amount No. Signature of Payee
SERVICE Pay
Tax PS GS PS GS Due
1 Isa Calipusan MHO - Nurse November-23 1,000.00 1,000.00 1
Development
2 Myra Leonora M. Salvaleon November-23 1,000.00 1,000.00 2
Management Officer IV
3 Hansel Serenio Clerk II-Project Inspector November-23 1,000.00 1,000.00 3

4 Ronaldo Mutia Market In-Charge November-23 1,000.00 1,000.00 4

5 Ruth Balbin Disbursing Officer November-23 1,000.00 1,000.00 5

Rex Anthony B.
6 CHO November-23 1,000.00 1,000.00 6
Sarigumba
7 Cleo Balbido Electrician November-23 1,000.00 1,000.00 7

8 Emily Manlegro Admin Aide November-23 1,000.00 1,000.00 8

9 Lucelyn Marfe PDO I November-23 1,000.00 1,000.00 9

10 Leonor Dalagan Admin Aide November-23 1,000.00 1,000.00 10

11 Adolf Marcos Alemania Purchase Officer November-23 1,000.00 1,000.00 11

GRAND TOTALS 11,000.00 11,000.00

(5) I HEREBY CERTIFY on my official oath that I have paid in cash to each
(1) I HEREBY CERTIFY on my official oath that the above PAYROLL is correct, and that the services stated official and employee whose name appears on the above roll the amount set
above have been duly rendered. Payment for such services is also hereby approved from the appropriation opposite his name, he having signed or marked his name, in my presence and
indicated. at the time that payment was made to him in acknowledgment of receipt of the
money paid him.

LYNN M. BASANES ________________, 2023 RUTH C. BALBIN

` Municipal Treasurer Date Disbursing Officer
(2) APPROVED for payment subject to pre-audit:
________________________,20__________________ Treasurer (6) I HEREBY CERTIFY on my official oath that each employee
(3) Preaudited and approved for payment in the amount of whose name appears on the above roll have been paid in cash or in
_______________________________________ (P _________) only. check, and in no other mode, the amount opposite his name. The total
(4) APPROVED:
of the payments made by means of this payroll amounts to Eleven
___________________________ ________________, 2023
Thousand Pesos Only (P 11,000.00 ) pesos only.
Provincial Auditor Date HON. RAYMOND G. JALA
Municipal Mayor
 (5) I HEREBY CERTIFY on my official oath that I have
(1) I HEREBY CERTIFY on my official oath paid in cash to each official and employee whose name
that the above PAYROLL is correct, and that appears on the above roll the amount set opposite his
the services stated above have been duly name, he having signed or marked his name, in my
rendered. Payment for such services is also presence and at the time that payment was made to
hereby approved from the appropriation him in acknowledgment of receipt of the money paid him.
indicated.
LYNN M. BASANES________________, 2023

` Municipal Treasurer Date RUTH BALBIN

(2) APPROVED for payment subject to pre-audit: Disbursing officer
________________________,20__________________ Treasurer (6) I HEREBY
(3) Preaudited and approved for payment in the amount of CERTIFY on my official
_______________________________________ (P _________) only. oath that each employee
___________________________ ________________, 2023 whose name appears on
Provincial Auditor Date the above roll have been
paid in cash or in check,
and in no other mode, the
amount opposite his
(4) APPROVED: name. The total of the
payments made by means
HON. RAYMOND G. JALA of this payroll amounts to
Municipal Mayor Eleven Thousand Pesos
Only (P 11,000.00 ) pesos
only.
 Payroll - Communication Expense (GF)
Period Covered: November-23

Net
PERIOD OF Gross
NAME OF PAYEE DESIGNATION GSIS PREMIUM MEDICARE EC Amount No. Signature of Payee
SERVICE Pay
PS GS PS GS Due
1 Raymond G. Jala Municipal Mayor Nov.2023 4,000.00 4,000.00 1
2 Maximilian Cempron Municipal Engineer Nov.2023 2,000.00 2,000.00 2

3 Orencia Jala Mun Assessor Nov.2023 2,000.00 2,000.00 3

4 Jelen P. Nalugon MA Nov.2023 2,000.00 2,000.00 4

5 Joel Espila MHO Nov.2023 2,000.00 2,000.00 5

6 Analou Luayon MSWDO Nov.2023 2,000.00 2,000.00 6

7 Avelyn Varquez BAC Secretariat Nov.2023 2,000.00 2,000.00 7

8 Mary Cris Arbuyes School Administrator Nov.2023 2,000.00 2,000.00 8

9 Christine C. Digal Nurse I Nov.2023 2,000.00 2,000.00 9

10 Genevieve J. Lawagon MDRRMA Nov.2023 2,000.00 2,000.00 10

11 Samuela Fuertes LCR Nov.2023 2,000.00 2,000.00 11

12 Edgar L. Calacar Mun. Accountant Nov.2023 2,000.00 2,000.00 12

13 Patrice Mica Varquez Salaga Municipal Budget Officer Nov.2023 2,000.00 2,000.00 13

14 Lynn Basanes Mun. Treasurer Nov.2023 2,000.00 2,000.00 14

15 Dioscora A. Sumampong HRMO V Nov.2023 2,000.00 2,000.00 15

GRAND TOTALS 32,000.00 - - - - - 32,000.00

(5) I HEREBY CERTIFY on my official oath that I have paid in cash to each
(1) I HEREBY CERTIFY on my official oath that the above PAYROLL is correct, and that the services stated above official and employee whose name appears on the above roll the amount set
opposite his name, he having signed or marked his name, in my presence and
have been duly rendered. Payment for such services is also hereby approved from the appropriation indicated. at the time that payment was made to him in acknowledgment of receipt of the
money paid him.

LYNN M. BASANES ________________, 2023 RUTH C. BALBIN

` Municipal Treasurer Date Disbursing Officer
(2) APPROVED for payment subject to pre-audit:
________________________,20__________________ Treasurer (6) I HEREBY CERTIFY on my official oath that each employee whose
(3) Preaudited and approved for payment in the amount of name appears on the above roll have been paid in cash or in check, and in
_______________________________________ (P _________) only. no other mode, the amount opposite his name. The total of the payments
made by means of this payroll amounts to Thirty-Two Thousand Pesos Only
___________________________ ________________, 2023 (P 32,000.00 ) pesos only.
Provincial Auditor Date (4) APPROVED:

HON. RAYMOND G. JALA

Municipal Mayor
 Payroll - Communication Expense and Internet Expense
Period Covered: Nov.2023

Net
PERIOD OF Gross
NAME OF PAYEE DESIGNATION GSIS PREMIUM MEDICARE EC Amount No. Signature of Payee
SERVICE Pay
PS GS PS GS Due

GRAND TOTALS 8,000.00 - - - - - 8,000.00

(5) I HEREBY CERTIFY on my official oath that I have paid in cash to each
(1) I HEREBY CERTIFY on my official oath that the above PAYROLL is correct, and that the services stated above official and employee whose name appears on the above roll the amount set
opposite his name, he having signed or marked his name, in my presence and
have been duly rendered. Payment for such services is also hereby approved from the appropriation indicated. at the time that payment was made to him in acknowledgment of receipt of the
money paid him.

LYNN M. BASANES ________________, 2022 MARCELINA MAQUINDANG

` Municipal Treasurer Date Disbursing Officer
(2) APPROVED for payment subject to pre-audit:
________________________,20__________________ Treasurer (6) I HEREBY CERTIFY on my official oath that each employee whose
(3) Preaudited and approved for payment in the amount of name appears on the above roll have been paid in cash or in check, and in
_______________________________________ (P _________) only. no other mode, the amount opposite his name. The total of the payments
made by means of this payroll amounts to Six Thousand Pesos Only (P
___________________________ ________________, 2022 6,000.00 ) pesos only.
Provincial Auditor Date (4) APPROVED:

HON. RAYMOND G. JALA

Municipal Mayor
 Payroll - Communication Expense
Period Covered: November-23

DEDUCTIONS Net
PERIOD OF Gross
NAME OF PAYEE DESIGNATION Wiholding GSIS PREMIUMMEDICARE EC Amount No. Signature of Payee
SERVICE Pay
Tax PS GS PS GS Due
1 Jocelyn B. Bandala MLGOO November-23 2,000.00 2,000.00 1

2 Police Capt. Eleazar Mellomida PNP Chief November-23 2,000.00 2,000.00 2

3 Leonardo Varquez SWMO November-23 2,000.00 2,000.00 3

4 Elmer Varquez Chief Tourism Offficer November-23 2,000.00 2,000.00 4

5 Tommy Efren Maquindang Tourism Manager November-23 2,000.00 2,000.00 5

6 Alexius Calipusan PESO Manager November-23 2,000.00 2,000.00 6

7 Marcelina S. Maquindang Liquidating officer November-23 2,000.00 2,000.00 7

8 Alfred Aurestila BPLO/LYDO November-23 2,000.00 2,000.00 8

9 Jovie Ann A. Cagoco Executive Assistant November-23 2,000.00 2,000.00 9

GRAND TOTALS 18,000.00 18,000.00

(5) I HEREBY CERTIFY on my official oath that I have paid in cash to each
(1) I HEREBY CERTIFY on my official oath that the above PAYROLL is correct, and that the services stated official and employee whose name appears on the above roll the amount set
above have been duly rendered. Payment for such services is also hereby approved from the appropriation opposite his name, he having signed or marked his name, in my presence and
indicated. at the time that payment was made to him in acknowledgment of receipt of the
money paid him.

LYNN M. BASANES ________________, 2023 RUTH C. BALBIN

` Municipal Treasurer Date Disbursing Officer
(2) APPROVED for payment subject to pre-audit:
________________________,20__________________ Treasurer (6) I HEREBY CERTIFY on my official oath that each employee
(3) Preaudited and approved for payment in the amount of whose name appears on the above roll have been paid in cash or in
_______________________________________ (P _________) only. check, and in no other mode, the amount opposite his name. The total
(4) APPROVED:
of the payments made by means of this payroll amounts to Eighteen
___________________________ ________________, 2023
Thousand Pesos Only (P 18,000.00 ) pesos only.
Provincial Auditor Date HON. RAYMOND G. JALA
Municipal Mayor
 Payroll -
Period Covered:

WAGES/RATES
PERIOD OF
NAME OF PAYEE POSITION RATE PER NO. of Days AMOUNT W/Tax (10 %) NET AMOUNT
SERVICE FIXED RATE
DAY

GRAND TOTALS 4,000.00 4,000.00

(5) I HEREBY CERTIFY on my official oath that I have paid in cash to each official and
employee whose name appears on the above roll the amount set opposite his name,
(1) I HEREBY CERTIFY on my official oath that the above PAYROLL is correct, and that the services he having signed or marked his name, in my presence and at the time that payment
stated above have been duly rendered. Payment for such services is also hereby approved from the was made to him in acknowledgment of receipt of the money paid him.
appropriation indicated.
________________, 2021
` Date
(2) APPROVED for payment subject to pre-audit:
________________________,20__________________ Treasurer (6) I HEREBY CERTIFY on my official oath that each employee whose
(3) Preaudited and approved for payment in the amount of name appears on the above roll have been paid in cash or in check, and in no
_______________________________________ (P _________) only. (4) APPROVED: other mode, the amount opposite his name. The total of the payments made
by means of this payroll amounts to Two Thousand Pesos Only (P 2,000.00 )
___________________________ ________________, 2021 pesos only.
Provincial Auditor Date HON. RAYMOND G. JALA
Municipal Mayor
 Signature of Payee

oath that I have paid in cash to each official and

above roll the amount set opposite his name,
in my presence and at the time that payment
receipt of the money paid him.

official oath that each employee whose

e been paid in cash or in check, and in no
is name. The total of the payments made
o Two Thousand Pesos Only (P 2,000.00 )
 PAYROLL (Communication Expense)
For the Month of NOVEMBER 2023
Net
NAME Barangay Days AMOUNT AMOUNT Undertime SIGNATURE
Amount

1) Alaba, Helen C. Mun. Vice Mayor 1 3,000.00 3,000.00 3,000.00 1)

2) Taldo, Alex Secretary 1 2,000.00 2,000.00 2,000.00 2)

3) Zafra, Alexander, Jr SB Member 1 2,000.00 2,000.00 2,000.00 3)

4) Tumanda, Jansyl Lovan SB Member 1 2,000.00 2,000.00 2,000.00 4)

5) Budiongan, Marylou O. SB Member 1 2,000.00 2,000.00 2,000.00 5)

6) Baquial, Erwin F. SB Member 1 2,000.00 2,000.00 2,000.00 6)

7) Calacar, Asterio B. SB Member 1 2,000.00 2,000.00 2,000.00 7)

8) Delfin-Odal, Rose Katherine L. SB Member 1 2,000.00 2,000.00 2,000.00 8)

9) Mandin, Efren B. SB Member 1 2,000.00 2,000.00 2,000.00 9)

10) Dango, Wenster C. SB Member 1 2,000.00 2,000.00 2,000.00 10)

11) Charles Adorable ABC 1 2,000.00 2,000.00 2,000.00 11)

12) Kent Henry Calipusan I SK Federated 1 2,000.00 2,000.00 2,000.00 12)

Total 25,000.00 25,000.00 25,000.00

3. I HEREBY CERTIFY on my official oath that I have this ______ day of

___________, 20___paid in cash to each person whose name appears on the
1. I HEREBY CERTIFY that each person whose name appears on this roll rendered above roll, the amount set opposite her name, she having presented herself,
service on the date indicated and for the same time indicated. established her identity, affixed her signature or thumbmark on the space
provided therefore. Unpaid services are indicated by red ink though the
column

Prepared by:
RUTH C. BALBIN
Disbursing Officer
IRISH LAO Approved by:
Payroll Maker
HON. HELEN C. ALABA
Municipal Vice-Mayor
 PAYROLL
PAYROLL -HONORARIA FOR JURY

NAME GROSS AMOUNT NET AMOUNT Signature of Payee DATE

1 HILARION ZAMORA

2 PETER NARON

3 LENARD SIMBIT

GRAND TOTALS -

(3) I HEREBY CERTIFY on my official oath that I have this

(1) I HEREBY CERTIFY that each person whose _________ day of ___________,20__ paid in cash to each person
name appears on this roll rendered service on the whose name appears on the above roll, the amount set opposite
date indicated and for the same time indicated. his name, he having presented himself, established his identity, and
affixed his signature or thumbmark on the space provided therefore.
Unpaid services are indicated by red ink through the column
` "Amount Paid".

LYNN M. BASANES RUTH BALBIN

Municipal Treasurer Disbursing officer
(4) APPROVED:

HON. RAYMOND G. JALA

Municipal Mayor
PAYROLL - DEC 6 - 20, 2014 (PLANTILLA & J.O. CASUALS)

PLANTILLA 48,519.75
ZIPLINE 71,758.45
TOURISM - LTC 311,699.64

431,977.84 -
Grand Total 431,977.84

PAYROLL - DEC 6 - 20, 2014 (PLANTILLA & J.O. CASUALS)

PLANTILLA 48,519.75
ZIPLINE 71,758.45
TOURISM - LTC 311,699.64

431,977.84
Grand Total 431,977.84