BALAS NATIONAL HIGH SCHOOL

(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Employee No.
Name of Employee SAMSON S. RAMISO
55110034
Office BALAS NATIONAL HIGH SCHOOL
Division LABASON, ZAMBOANGA DEL NORTE
Particulars Amount(P)
PAYMENT FOR JULY 2024 MEAL ALLOWANCE 250.00

TOTAL 250

Purpose: NLC MEAL ALLOWANCE

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
SAMSON S. RAMISO VICTORIA V. DORIMON
Name
Date: Date:
 BALAS NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Employee No.
Name of Employee ENRIQUE E. TIEMPO
6484439
Office BALAS NATIONAL HIGH SCHOOL
Division LABASON, ZAMBOANGA DEL NORTE
Particulars Amount(P)
PAYMENT FOR JULY 2024 MEAL ALLOWANCE 250.00

250.00

Purpose: NLC MEAL ALLOWANCE

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
ENRIQUE E. TIEMPO VICTORIA V. DORIMON
Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JASON P. ACANA Employee No.
6280336
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
GUBAN – SIRAWAI 150.00
SIRAWAI – GUBAN 150.00

300.00

Purpose: TO ATTEND THE 4 DAY LIVE OUT DANCE, MUSIC AND ART SEMINAR-WORKSHOP FOR
ELEMENTARY AND SECONDARY TEACHERS

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JASON P. ACANA JOCELYN B. MONTIMOR

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JASON P. ACANA Employee No.
6280336
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
GUBAN – CAYAMCAM 150.00
CAYAMCAM - GUBAN 150.00

300.00

Purpose: TO ATTEND THE 4 DAY LIVE OUT DANCE, MUSIC AND ART SEMINAR-WORKSHOP FOR
ELEMENTARY AND SECONDARY TEACHERS

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JASON P. ACANA JOCELYN B. MONTIMOR

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JASON P. ACANA Employee No.
6280336
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
GUBAN – SIOCON 200

200

Purpose: TO ATTEND THE BOY SCOUT BTC FOR OUTFIT ADVISOR 2019 (19-008)

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JASON P. ACANA JOCELYN B. MONTIMOR

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JASON P. ACANA Employee No.
6280336
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
SIRAWAI – GUBAN 150.00

150.00

Purpose: TO ATTEND TRAINING WORKSHOP ON THE DEVELOPMENT OF TEACHERS’ ENHANCED

CURRICULUMGUIDE OF TLE/TVL SPECIALIZATION

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JASON P. ACANA JOCELYN B. MONTIMOR

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee NORMAN M. DELA PEÑA Employee No.

Office DACON NATIONAL HIGH SCHOOL

Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
LILOY - GUBAN 300.00

Purpose: TO ATTEND NATIONAL SCHOOL BUILDING INVENTORY SEMINAR AT BAYBAY CENTRAL

SCHOOL, LILOY, DISTRICT II

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed NORMAN M. DELA PEÑA JOCELYN B. MONTIMOR

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JOCELYN B. MONTIMOR Employee No.
5330014
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
GUBAN – SIRAWAI 300.00

300.00

Purpose: TO GET MODULES AND OFFICE SUPPLIES FROM SIRAWAI

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JOCELYN B. MONTIMOR ARACELI C. TOMBOC

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JOCELYN B. MONTIMOR Employee No.
5330014
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
IPIL - GUBAN 300.00

300.00

Purpose: TO PURCHASED OFFICE SUPPLIES AT PSDBM, IPIL

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JOCELYN B. MONTIMOR SUSAN M. FELIZARTA

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JOCELYN B. MONTIMOR Employee No.
5330014
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
GUBAN - CAYAMCAM 250.00

250.00

Purpose: TO PURCHASED OFFICE SUPPLIES AT PSDBM, IPIL

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JOCELYN B. MONTIMOR ARACELI C. TOMBOC

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JOCELYN B. MONTIMOR Employee No.
5330014
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
SIRAWAI – GUBAN 150.00

150.00

Purpose: TO ATTEND DIVISION TRAINING OF SCHOOL HEADS ON INCLUSIVE EDUCATION AND SPECIAL
CURRICULUM PROGRAMS AT TOP PLAZA HOTEL, DIPOLOG CITY

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JOCELYN B. MONTIMOR ARACELI C. TOMBOC

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JOCELYN B. MONTIMOR Employee No.
5330014
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
IPIL – CAYAMCAM 200.00

200.00

Purpose: TO PURCHASED OFFICE SUPPLIES AT PSDBM, IPIL

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JOCELYN B. MONTIMOR ARACELI C. TOMBOC

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JOCELYN B. MONTIMOR Employee No.
5330014
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
GUBAN – CAYAMCAM 250.00

250.00

Purpose: TO GET LAND BANK STATEMENT AND GET CHECK BOOK FOR JUNIOR & SENIOR HIGH
SCHOOL

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JOCELYN B. MONTIMOR ARACELI C. TOMBOC

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JOCELYN B. MONTIMOR Employee No.
5330014
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
CAYAMCAM – LILOY 260.00

260.00

Purpose: TO GET LAND BANK STATEMENT AND GET CHECK BOOK FOR JUNIOR & SENIOR HIGH
SCHOOL

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JOCELYN B. MONTIMOR ARACELI C. TOMBOC

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee WELFIE O. ANINO Employee No.

Office DACON NATIONAL HIGH SCHOOL

Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
IPIL – LILOY 150.00
LILOY – IPIL 150.00

300.00

Purpose: TO GET LAND BANK STATEMENT BOOK FOR JUNIOR & SENIOR HIGH SCHOOL MOOE AT
LAND BANK LILOY

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed WELFIE O. ANINO JOCELYN B. MONTIMOR

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee WELFIE O. ANINO Employee No.

Office DACON NATIONAL HIGH SCHOOL

Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
GUBAN – IPIL 200.00

200.00

Purpose: TO GET LAND BANK STATEMENT BOOK FOR JUNIOR & SENIOR HIGH SCHOOL MOOE AT
LAND BANK LILOY

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed WELFIE O. ANINO JOCELYN B. MONTIMOR

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee WELFIE O. ANINO Employee No.

Office DACON NATIONAL HIGH SCHOOL

Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
IPIL - GUBAN 200.00

200.00

Purpose: Purpose: TO GET LAND BANK STATEMENT BOOK FOR JUNIOR & SENIOR HIGH SCHOOL
MOOE AT LAND BANK LILOY

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed WELFIE O. ANINO JOCELYN B. MONTIMOR

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JOCELYN B. MONTIMOR Employee No.
5330014
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
SIRAWAI – GUBAN 150.00

150.00

Purpose: TO ATTEND SEMINAR ON 2020 PARTNERSHIP FOCUS GROUP DISCUSSION CUM

ORIENTATION ON SCHOOL (NEEDS) PARTNERSHIP DATABASE SYSTEM AT MIBANG HOTEL, DIPOLOG
CITY

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JOCELYN B. MONTIMOR ARACELI C. TOMBOC

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee LIZA A. PASIA Employee No.
5330018
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)

Guban- Liloy 305.00

Liloy - Guban 305.00

610.00

Purpose: TO ATTEND DIVISION SCHOOLS PRESS CONFERENCE AT LILOY NATIONAL HIGH SCHOOL,
LILOY, ZAMBOANGA DEL NORTE.

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed LIZA A. PASIA JOCELYN B. MONTIMOR

Name
DATE: DATE:
 DACON NATIONAL HIGH SCHOOL
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPT
Pursuant to COA Circular No. 2017-001 dated June 19,2017
Name of Employee JASON P. ACANA Employee No.
6280336
Office DACON NATIONAL HIGH SCHOOL
Division SIRAWAI, ZAMBOANGA DEL NORTE
Particulars Amount(P)
GUBAN – CAYAMCAM 150.00
CAYAMCAM - GUBAN 150.00

300.00

Purpose: TO ATTEND CONFERENCE MEETING WITH SDS, PEDRO MELCHOR M. NATIVIDAD. CSEE

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 wilful falsification of statement is punishable by law.
Certified Correct: Noted By:
Signature

Printed JASON P. ACANA JOCELYN B. MONTIMOR

Name
DATE: DATE: