Obligation Request: Republic of The Philippines Department of Education
Obligation Request: Republic of The Philippines Department of Education
OBLIGATION REQUEST
Payee Office Address
Responsibility Center Particulars P.P.A
No.
Account Code
Amount
Total
A.
Certified
Charges to appropriation/allotment necessary, lawful and incurred under my direct supervision Supporting documents valid, proper and legal
B. Certified
Allotment available and obligated for the purpose as indicated above
Signature
EMMA I. CORNEJO
Schools Division Superintendent
Head, Requesting Office/Authorized Representative
SONIA M. LASALA
Accountant ll
Head, Budget Unit/Authorized Representative
DISBURSEMENT VOUCHER
Mode of Payment Payee
MDS Check Commercial Check ADA
No. Date :
Others
TIN/Employee No.
OR/BUR No.
EXPLANATION
AMOUNT
A. Certified
Cash available Subject to Authority to Debit Account Supporting documents complete
(when applicable)
Signature Printed Name Position Date JEV No. Date Date Bank Name Printed Name Date
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sept
Oct
Prepared By:
Approved:
School Head
Nov
Dec
TOTAL
753 754
766 767
771 772 773 774 775 781 784 786 787 795 796 797
841
892
969
School _______________________________________________________ Annual School MOOE Allocation: _______________________________ PARTICULARS Water Expenses Electricity Expenses Telephone Expenses-Landline Telephone Expenses-Mobile Internet Expenses Office Supplies Expenses School Supplies Expenses General/Janitorial Services Fuel, Oil and Lubricants Expenses Repairs and Maintenance-Buildings and Structures Travel Expenses Training and Scholarship Expenses Postage and Deliveries Medical, Dental and Laboratory Supplies Expenses Cable, Satellite and Telegraph Repairs and Maintenance Furniture and Fixtures Repairs and Maintenance Office Equipment Repairs and Maintenance School Equipment Security Services Other MOOE TOTAL
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Prepared by:
Approved:
No: ________________________________
LIQUIDATION REPORT
PARTICULARS
TOTAL AMOUNT SPENT AMOUNT OF CASH ADVANCE PER DV NO. AMOUNT REFUNDED PER O.R. NO. AMOUNT TO BE REIMBURSED DATED DATED
101,610.22 -
A] Certified; Correctness of the above data B.] Certified: Purpose of travel/cash advance C.] Certified: Supporting documents complete duly accomplished and proper
Claimant
Immediate Supervisor
______________
______________ ______________
ocuments complete
[NAME OF SCHOOL] [NAME OF DISTRICT] [NAME OF DIVISION] [ADDRESS] FOR THE PERIOD _________________________________ CASH DISBURSEMENT REGISTER Type of Working Fund: MOOE WORKING FUND Control No. BREAKDOWN OF PAYMENTS ACCOUNT NAME/AMOUNT
DATE
REFERENCE
PAYEE
PARTICULARS
TOTAL
APPROVED:
PRINCIPAL/DISBURSING OFFICER
DIVISION ACCOUNTANT
DATE
DATE
DATE
CASH IN BANK Date Check No. Payee Particulars Deposits Withdrawals/ Payments Balance
TOTALS
Prepared by:
Certified Correct:
Noted by:
_________________________________ Accountant
Date
DV/Payroll No
Payee
Nature of Payment
CERTIFICATION I hereby certify that this Report of Disbursement in ________ sheet(s) is a full, true and correct statement of the disbursements made by me and that this is in liquidation of the cash advance granted last ________ in the amount of P________ per Check No. ________ dated ________.
____________________ Date
Amount
_______________ Date
Amount
A Requested by:
B Paid by:
Date: _________________
__________ __________
2. To be filled up upon liquidation Total Amount Granted Total Amount Paid per OR No. _______ __________ __________
__________
Date: ________________
DATE
PCV No.
PARTICULARS
Receipts
Payments
Balance
Standard Form Number: SF-GOOD-59 Revised: May 24, 2004 Standard Form Title: Purchase Request
PURCHASE REQUEST
STOCK NO.
UNIT
ITEM DESCRIPTION
QTY.
UNIT COST
Approved by:
_____________________ _____________________
TOTAL COST
_______________________ _______________________
Approved by:
REQUEST FOR QUOTATION Date: __________________ Quotation No.: ___________ ___________________________________ ___________________________________ Please quote your lowest price on the item/s listed below, subject to the General Conditions on the last page, stating the shortest time of delivery and submit your quotation duly signed by your representative not later than 3 days in the return envelop attached herewith.
Procurement Officer
NOTE:
1. All entries must be typewritten. 2. Delivery period within 7 calendar days. 3. Warranty shall be for a period of six (6) months for supplies and naterials. one (1) year for equipment, from date of acceptance by the Procuring Entity. 4. Price validity shall be for a period of 30 calendar days. 5. G-EPS registration certificate shall be attached upon submission of the quotation. 6. Bidders shall submit original brochures showing certifications of the product being offered.
Approved Budget for the Contract: ITEM NO. Item & Description
Qty
Unit
Unit Cost
Bidders Quote
Total Brand and Model Delivery Period Warranty Price Validity : __________________ : __________________ : __________________ : __________________
After having carefully read and accepted your General Conditions, I/We quote you on the items at prices noted above.
Printed Name/Signature
Date
Total Cost
DEPARTMENT OF EDUCATION Agency Project Reference Number: ____________ Name of Project: ____________________ Location of the Project: _______________
ABSTRACT OF BIDS NAME OF BIDDERS ITEM NO. DESCRIPTION QTY UNIT UNIT COST TOTAL COST UNIT COST TOTAL COST UNIT COST TOTAL COST UNIT COST TOTAL COST
Project Reference Number Location of the Project Standard Form Number: SF-GOOD-58 Revised on: May 24, 2004 Standard Form Title: Purchase Order
PURCHASE ORDER __________________________________ Agency / Procuring Entity Supplier : Address : E-mail Address : Telephone No. : TIN : Gentlemen: Please furnish this office the following articles subject to the terms and conditions contained herein: D.O. No. : Date : Mode of Procurement :
(Total Amount in Words) In case of Failure to make the full delivery within the time specified above, a penalty of onetenth (1/10) of one (1) percent for every day of delay shall be imposed. Very truly yours, ______________________________ Authorized Official Conforme: _____________________________________________ Signature over printed name of Supplier ________________________ Date Funds Available: _______________________________________ Chief Accountant
: _______________________________ : _______________________________
AMOUNT
10) of one
truly yours,
_________________ _________________
Agency Supplier : ____________ P.O. # : ______________ Date : ___________ Requisitioning Office/Dept.: ___________ AR No.: ____________ Invoice No.: _________ Date : __________ Administrative Section : _________________
Item #
Unit
Description
_____ Complete
_____ Partial
Inspector
Property Custodian
Quantity
__ Partial
RIS No. : ___________ Responsibility Center Code: _____________________________ SAI No. : ___________ Requisition
Stock No.
Unit
Description
QTY
QTY
Purpose: __________________________________________________________________________________ Requested By: Signature: Printed Name: Designation: Date: Approved By: Issued By
Place to be Visited
I hereby certify that: (1) I have reveiwed the foregoing itinerary; (2) the travel is necessary to the service (3) the period covered is reasonable; (4) the expenses claimed are proper.
____________
Total
___________
___________
Agency Head
Address
Designation
Date
I hereby certify that I have completed the travel authorized in the Itinerary of Travel dated ____________ under condition indicated below : ( ) Strictly in accordance with the approved itinerary ( ) Cut short as explained below. Excess payment in the amt of is refunded under O.R. No. dated . ( ) Other deviation as explained below : Explanation or justification below :
Respectfully yours,
Officer or Employee
On evidence and information of which I have knowledge, the travel was actually undertaken.
Immediate Supervisor
AUTHORITY TO TRAVEL
NAME:
OFFICIAL STATION:
DESTINATION:
DATE:
PURPOSE OF TRAVEL:
CHARGEABLE AGAINST:
Requested by:
Recommending Approval:
APPROVED:
the amount of
(Payments for subsistence, services,
the amount of
(Payments for subsistence, services,
PAYEE
PAYEE
WITNESS
WITNESS
1 For the Period From Part I 2 Taxpayer Identification Number 3 Payee's Name (Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals) 4 Registered Address 5 Foreign Address Payor Information 6 Taxpayer Identification Number 7 Payor's Name (Last Name, First Name, Middle Name for Individuals) (Registered Name for Non-Individuals) 8 Registered Address PART II Income Payments Subject to Expanded Withholding Tax ATC Details of Monthly Income Payments and Tax Withheld for the Quarter AMOUNT OF INCOME PAYMENTS 1st Month of the Quarter 2nd Month of the Quarter 3rd Month of the Quarter Total (MM/DD/YY)
Total
Money Payments Subject to Withholding of Business Tax (Government & Private)
Total
We declare, under the penalties of perjury, that this certificate has been made in good faith, verified by me, and to the best of my knowledge and belief, pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Payor/Payor's Authorized Representative/Accredited Tax Agent (Signature Over Printed Name) Tax Agent Accreditation No./Attorney's Roll No. (if applicable) Conforme: Payee/Payee's Authorized Representative/Accredited Tax Agent (Signature Over Printed Name) Tax Agent Accreditation No./Attorney's Roll No. (if applicable) TIN of Signatory Title/Position of Signatory TIN of Signatory
Title/Position of Sign
Date of Issuance
Date of Expiry
Date of Issuance
Date of Expiry
2307
September 2005 (ENCS)
Title/Position of Signatory
Date of Expiry
sition of Signatory
Date Signed
Date of Expiry
ATC IND WI 010 WI 011 WI 020 WI 021 WI 030 WI 031 WI 040 WI 041 WI 050 W 051 WI 060 WI 061 WI 070 WI 071 WI 080 WI 081 WI 090 WI 091 WI 100 WI 110 WI 120 WI 130 WI 140 WI 141 WI 151 WI 150 WI 152 WI 153 WI 156 WI 640 WI 157 WI 158 WI 160 WI 159 WI 515 WI 530 WI 535 WI 540 WI 555 WI 556 WI 557 WI 558 WI 610 WI 620 WI 630 WB 030 WB 040 WB 050 WB 070 WB 090
17 18 19 20 21 22 23 24 25 26 27 28
29 30 31
32 Tax on carriers and keepers of garages 33 Franchise Tax on Gas and Water Utilities 34 Franchise Tax on radio & TV broadcasting companies whose annual gross receipts does not exceed P10M and who are not Value-Added Tax registered taxpayers 35 Tax on life insurance premiums 36 Tax on Overseas Dispatch, Message or Conversation originating from the Phils. Tax on Banks and Non-Bank Financial Intermediaries Performing Quasi-Banking Functions 37 A. On interest, commissions and discounts from lending activities as well as income from financial leasing, on the basis of the remaining maturities of instrument from which such receipts are derived - Maturity period is five years or less 5% - Maturity period is more than five years 1% 38 Tax on royalties, rentals of property, real or personal, profits from exchange & all other items treated as gross income under Section 32 of the Code 7% 39 On net trading gains within the taxable year on foreign currency,debt securities, derivatives, and other
financial instruments 7% Tax on Other Non-Banks Financial Intermediaries Not Performing Quasi-Banking Functions A. On interest, commissions and discounts from lending activities as well as income from financial leasing, on the basis of the remaining maturities of instrument from which such receipts are derived 40 - Maturity period is five years or less 5% - Maturity period is more than five years 1% 41 5% 42 B. On all other items treated as gross income under the code 10% 43 Business Tax on Agents of foreign insurance co.- insurance agents 5% 44 Business Tax on Agents of foreign insurance co.-owner of the property 45 Tax on International Carriers 46 Tax on Cockpits 47 Tax on Cabaret, night and day club 48 Tax on Boxing exhibitions 49 Tax on Professional basketball games 50 Tax on jai-alai and race tracks 51 Tax on sale, barter or exchange of stocks listed & traded through Local Stock Exchange 52 Tax on shares of stock sold or exchanged through initial and secondary public offering - Not over 25% 4% - Over 25% but not exceeding 33 1/3 % 2% - Over 33 1/3% 1% 53 54 55 56 Person exempt from VAT under Sec. 109 (v) (Government withholding agent) Person exempt from VAT under Sec. 109 (v) (Private withholding agent) Vat Withholding on Purchase of Goods (with waiver of privilege to claim input tax credits) Vat Withholding on Purchase of Services (with waiver of privilege to claim input tax credits) 3% 3% 10% 10%
WB 104
WB 108 WB 109 WB 110 WB 120 WB 121 WB 130 WB 140 WB 150 WB 160 WB 170 WB 180 WB 200 WB 201 WB 202 WB 203 (Individual & Corporate) WB 080 WB 082 WV 012 WV 022
ATC IND WI 010 WI 011 WI 020 WI 021 WI 030 WI 031 WI 040 WI 041 WI 050 W 051 WI 060 WI 061 WI 070 WI 071 WI 080 WI 081 WI 090 WI 091 WI 100 WI 110 WI 120 WI 130 WI 140 WI 141 WI 151 WI 150 WI 152 WI 153 WI 156 WI 640 WI 157 WI 158 WI 160 WI 159 WI 515 WI 530 WI 535 WI 540 WI 555 WI 556 WI 557 WI 558 WI 610 WI 620 WI 630 CORP WC 010 WC 011
WC 156 WC 640 WC 157 WC 158 WC 160 WC 515 WC 535 WC 540 WC 555 WC 556 WC 557 WC 558 WC 610 WC 620 WC 630
WB 104
WB 108 WB 109 WB 110 WB 120 WB 121 WB 130 WB 140 WB 150 WB 160 WB 170 WB 180 WB 200 WB 201 WB 202 WB 203 (Individual & Corporate) WB 080 WB 082 WV 012 WV 022
MONTHLY CASH PROGRAM CALENDAR YEAR 2008 District ___________________________________________________________________________________ Annual District MOOE Allocation: _______________________ PARTICULARS Water Expenses Electricity Expenses Telephone Expenses-Landline Telephone Expenses-Mobile Internet Expenses Office Supplies Expenses School Supplies Expenses General/Janitorial Services Fuel, Oil and Lubricants Expenses Repairs and Maintenance-Buildings and Structures Jan Feb Mar Apr May Jun Jul Aug Sept Oct
1 2 3 4 5 6 7 8 9 10
TOTAL
Prepared by:
Approved:
_______________________________ PSDS
Nov
Dec
Total
MONTHLY CASH PROGRAM CALENDAR YEAR 2008 School ___________________________________________________________________________________ Annual School MOOE Allocation: _______________________ PARTICULARS Water Expenses Electricity Expenses Telephone Expenses-Landline Telephone Expenses-Mobile Internet Expenses Office Supplies Expenses School Supplies Expenses General/Janitorial Services Fuel, Oil and Lubricants Expenses Repairs and Maintenance-Buildings and Structures Travel Expenses Training and Scholarship Expenses Postage and Deliveries Petty Cash Fund Medical, Dental and Laboratory Supplies Expenses Cable, Satellite and Telegraph Repairs and Maintenance Furniture and Fixtures Repairs and Maintenance Office Equipment Repairs and Maintenance School Equipment Security Services Other MOOE TOTAL Jan Feb Mar Apr May
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Prepared by:
Jun
Jul
Aug
Sept
Oct
Nov
Dec
Total
Approved: