NATIONAL TAX RESEARCH CENTER Forms -...

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NATIONAL TAX RESEARCH CENTER

Forms

Conforms to ISO 9001:2015

December 19, 2016

© 2016; All rights reserved. Document is uncontrolled unless otherwise marked; uncontrolled documents

are not subject to update notification.


Branch Forms Code

Planning and Coordinating Branch

Branch Performance Commitment and Review

NTRC-QMS-PAWIM-FR-001

Quarterly Physical Report of Operation NTRC-QMS-PAWIM-FR-002

AFB Disbursement Voucher NTRC-QMS-PAWIM-FR-003

Itinerary of Travel NTRC-QMS-PAWIM-FR-004

Reimbursement Expense Receipt NTRC-QMS-PAWIM-FR-005

Certification of Travel Completed NTRC-QMS-PAWIM-FR-006

AFB – HR Division Payroll NTRC-QMS-PAWIM-FR-007

Individual Performance and Commitment


AFB – IT Unit Website Form 1 NTRC-QMS-PAWIM-FR-009

Website Form 2 NTRC-QMS-PAWIM-FR-010

Website Form 3 NTRC-QMS-PAWIM-FR-011

AFB – Administrative Division

Petty Cash Voucher NTRC-QMS-PAWIM-FR-012

Report on Paid Petty Cash Voucher NTRC-QMS-PAWIM-FR-013

Petty Cash Fund Custodian NTRC-QMS-PAWIM-FR-014

Petty Cash Fund Register NTRC-QMS-PAWIM-FR-015

Stock Card NTRC-QMS-PAWIM-FR-016

Inventory Custodian Slip NTRC-QMS-PAWIM-FR-017

Purchase Request NTRC-QMS-PAWIM-FR-018

Purchase Order NTRC-QMS-PAWIM-FR-019

Inspection and Acceptance Report NTRC-QMS-PAWIM-FR-020

Requisition and Issue Slip NTRC-QMS-PAWIM-FR-021

Reports of Supplies and Materials Issued


Waste Material Report NTRC-QMS-PAWIM-FR-023

Report on the Physical Count of Inventories


Report of Accountability of Accountable Forms


Property Card NTRC-QMS-PAWIM-FR-026

Property, Plant and Equipment Ledger Card


Property Acknowledgement Receipt NTRC-QMS-PAWIM-FR-028

PROCEDURES AND WORK INSTRUCTIONS MANUAL

List of Forms

Code: Revision No.: 0 Effectivity Date: 19 December 2016 Page: i

Prepared by:

TERESITA L. SOLOMON Acting Deputy Executive Director

Approved by:

TRINIDAD A. RODRIGUEZ Acting Executive Director


Branch Forms Code

AFB – Administrative Division

Report on the Physical Count of Property, Plant and Equipment


Inventory and Inspection Report of Unserviceable Property


Report of Lost, Stolen, Damaged or Destroyed Property


AFB – Accounting Division

General Journal NTRC-QMS-PAWIM-FR-032

Cash Receipts Journal NTRC-QMS-PAWIM-FR-033

Cash Disbursements Journal NTRC-QMS-PAWIM-FR-034

Check Disbursements Journal NTRC-QMS-PAWIM-FR-035

General Ledger NTRC-QMS-PAWIM-FR-036

Subsidiary Ledger NTRC-QMS-PAWIM-FR-037

Registry of Revenue and Other Receipts - Summary


Registry of Revenue and Other Receipts NTRC-QMS-PAWIM-FR-039

Notice of Budget Utilization Request and Status Adjustment


Aging of Due and Demandable NTRC-QMS-PAWIM-FR-041

Monthly Report of Disbursements NTRC-QMS-PAWIM-FR-042

Quarterly Report of Revenue and Other Receipts


Order of Payment NTRC-QMS-PAWIM-FR-044

Notice of Obligation Request and Status Adjustment


Journal Entry Voucher NTRC-QMS-PAWIM-FR-046

Advice to Debit Account Disbursements Journal


Index of Payments NTRC-QMS-PAWIM-FR-048

Cash Disbursements Record NTRC-QMS-PAWIM-FR-049

Report of Cash Disbursements NTRC-QMS-PAWIM-FR-050

Liquidation Report NTRC-QMS-PAWIM-FR-051

Schedule of Accounts Payable NTRC-QMS-PAWIM-FR-052

Schedule of Accounts Receivable NTRC-QMS-PAWIM-FR-053

Registry of Accounts Written off NTRC-QMS-PAWIM-FR-054

Supplies Ledger Card NTRC-QMS-PAWIM-FR-055

Bank Reconciliation Statement, Cash – MDS


Bank Reconciliation Statement, Cash – Local Currency, Savings Account



List of Forms

Code: Revision No.: 0 Effectivity Date: 19 December 2016 Page: ii

Prepared by:


Approved by:



Branch Forms Code

AFB – Budget and Cash Division

Obligation Request and Status NTRC-QMS-PAWIM-FR-058

Summary of LDDAD-ADAs Issued and Invalidated ADA Entries


Report of Advice to Debit Account Issued NTRC-QMS-PAWIM-FR-060

Budget Utilization Request and Status NTRC-QMS-PAWIM-FR-061

Statement of Appropriations, Allotments, Obligations Disbursements and Balances


Statement of Appropriations, Allotments, Obligations Disbursements and Balances by Object of Expenditures


List of Allotments and Sub-Allotments NTRC-QMS-PAWIM-FR-064

Statement of Approved Budget, Utilizations, Disbursements and Balances


Summary of Approved Budget, Utilizations, Disbursements and Balances by Object of Expenditures


Notice of Dishonored Checks NTRC-QMS-PAWIM-FR-067

Report of Collections and Deposits NTRC-QMS-PAWIM-FR-068

Cash Receipts Register NTRC-QMS-PAWIM-FR-069

Cash Receipts Record NTRC-QMS-PAWIM-FR-070

Registry of Allotments and Notice of Allocation


Checks and Advice to Debit Account Disbursement Record


Report of Checks Issued NTRC-QMS-PAWIM-FR-073

Cash in Bank Register NTRC-QMS-PAWIM-FR-074

Advice of Checks Issued and Cancelled NTRC-QMS-PAWIM-FR-075

List of Due and Demandable Accounts Payable – Advice to Debit Accounts (LDDAP-ADA)


Cash Disbursements Register NTRC-QMS-PAWIM-FR-078


List of Forms

Code: Revision No.: 0 Effectivity Date: 19 December 2016 Page: iii

Prepared by:


Approved by:



FORMS

Planning and Coordinating Branch

Branch Performance Commitment and Review

Prepared by:

NEDINIA B. MENDIOLA OIC, Planning and Coordinating Branch

Approved by:

TRINIDAD A. RODRIGUEZ

Acting Executive Director

Code: NTRC-QMS-PAWIM-FR-001 Revision No.: 0 Effectivity Date: 19 December 2016 Page: 1 of 78


FORMS Planning and Coordinating Branch

Quarterly Physical Report of Operation

Prepared by:

NEDINIA B. MENDIOLA OIC, Planning and Coordinating Branch

Approved by:



Current Year Appropriations

Supplemental Appropriations

Continuing Appropriations

Off-Budget Account

2 3 4 5 6 7=(3+4+5+6) 8 9 10 11 12=(8+9+10+11) 13 14

Part A

I. Operations

MFO 1 - [Description]

Performance Indicator (Set 1)

Quantity

Quality

Timeliness

…continue down to the last Set of PIs

…continue down to the last MFO

II.Projects

Target 1

Target 2

… continue down to the last target

… continue down to the last project

III.Automatic Appropriations

Special Account in the General Fund (Please specify)

MFO 1 - [Description]

Performance Indicator (Set 1)

… continue down to the last SAGF/MFO

Part B

Major Programs/Projects

KRA No. 1 - Anti-Corruption, Transparent, Accountable

and Participatory Governance

Program Budgeting: Education Program

MPP

Target 1

Target 2

…

Other Major Programs and Projects

PAP

Target 1

Target 2

…

…continue down to the last PAP

…continue down to the last Program Budgeting

…continue down to the last KRA

Prepared By: In coordination with: Approved by:

Date: ________________________ Date: ________________________ Date: ________________________

1

Nedina B. Mendiola Cecilia V. Salvatierra Trinidad A. Rodriguez

OIC, Planning and Coordinating Branch Chief, Budget and Cash Division Acting Executive Director

Variance as of

_______Remarks

1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total 1st Quarter 2nd Quarter 3rd Quarter

Physical Accomplishments

4th Quarter Total

Organization Code (UACS) : _____________________________________________

ParticularsUACS

CODE

Physical Targets

Operating Unit : 01

BAR No. 1

QUARTERLY PHYSICAL REPORT OF OPERATION

As at ______________________

Department : Department of Finance

Entity Name : National Tax Research Center


FORMS AFB

Disbursement Voucher

Prepared by:

GIAN CARLO D. RODRIGUEZ Chief Administrative Officer

Approved by:




MDS Check Commercial Check ADA Others (Please specify)

_________________

A.

B. Accounting Entry:

C. Certified: D. Approved for Payment

Cash available

Subject to Authority to Debit Account (when applicable)

Supporting documents complete and amount claimed Supporting documents complete and amount claimed

proper

E. Receipt of Payment JEV No.

Date

Official Receipt No. & Date/Other Documents

Check/ ADA No. :Date : Bank Name & Account Number:

Signature :Date : Printed Name:

Date Date

Printed Name Printed Name

PositionGrace A. Manalo

PositionTrinidad A. Rodriguez

Chief, Accounting Division Acting Executive Director

Approved for Payment

Signature Signature

Account Title UACS Code Debit Credit

Amount Due

Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

Particulars

Printed Name, Designation and Signature of Supervisor

National Tax Research Center Fund Cluster : 01

DISBURSEMENT VOUCHERDate :

DV No. :

________________________________________

Mode of Payment

PayeeTIN/Employee No.: ORS/BURS No.:

Address

Responsibility Center MFO/PAP Amount


FORMS AFB

Itinerary of Travel

Prepared by:


Approved by:




Fund Cluster: 01

Means of Per

Departure Arrival Transportation Diem

TOTAL

Prepared by :

Approved by:

ITINERARY OF TRAVEL

No.: _______________

Name : ____________________________________________Date of Travel : _____________________________

Position : __________________________________________Purpose of Travel : __________________________

(Destination)

Places to be visited

Official Station : _____________________________________ ___________________________________________

DateT I M E

Transporstation Others

Total Amount

I certify that : (1) I have reviewed the

foregoing itinerary, (2) the travel is

necessary to the service, (3) the period

covered is reasonable and (4) the

expenses claimed are proper.

Signature over Printed Name Signature over Printed Name

Immediate Supervisor Agency Head/Authorized Representative

_____________________________________________

Signature over Printed Name

____________________________________ ______________________________________________


Entity Name: National Tax Research Center Fund Cluster : 01

Date : _______________________ RER No. : ___________________

Address ________________________________________________

purpose, distance, inclusive points of travel, etc.)

PAYEE

Name/Signature __________________________________________

Address ________________________________________________

WITNESS

Name/Signature __________________________________________

_________________________________________________________

RECEIVED from ______________________________________

(Name)

_________________________________________________ the amount

(Official Designation)

of __________________________________________ (P__________)

(In Words) (in Figures)

in payment for _______________________________________________

(Payments for subsistence, services,

_________________________________________________________

rental or transportation should show inclusive dates,

FORMS AFB

Reimbursement Expense Receipt

Prepared by:


Approved by:





Entity Name: National Tax Research Center Fund Cluster: 01

___________________________

___________________________

Director in-Charge Station

I HEREBY CERTIFY THAT I have completed the travel as authorized in the Travel

Order/Itinerary of Travel No. ________ dated ________ under conditions indicated below:

/ x / Strictly in accordance with the approved itinerary.

/ / Cut short as explained below. Excess payment in the amount of

P_______ was refunded under O. R. No. ________ dated __________

/ / Extended as explained below, additional itinerary was submitted

/ / Other deviation as explained below.

Explanation or justifications:

______________________________________________________________________________

Evidence of travel:

__________________________________________________________________________________

__________________________________________________________________________________

_______________________________

Respectfully submitted:

_____________________________

Name of Employee

On evidence and information of which I have the knowledge, the travel was actually

undertaken.

Approved:

________________________

Name of Director

FORMS AFB

Certification of Travel Completed

Prepared by:


Approved by:





FORMS AFB – HR Division

Payroll

Prepared by:

LORELLI D. VILLAFLORES Chief, HR Division

Approved by:



Entity Name : National Tax Research Center Payroll No. : _______________________

Fund Cluster : 01 Sheet _________of __________Sheets

A C

Date

B D E

ORS/BURS No. : __

Date : _______

JEV No. : _________

Date Date : _________

PAYROLL

We acknowledge receipt of cash shown opposite our name as full compensation for services rendered for the period covered.

Serial

No.Name Position

Employe

e No.

COMPENSATIONS D E D U C T I O N S

Net Amount Due Signature of RecipientSalaries

and

Gross

Amount

Total

Deductio

Grace A. Manalo

Chief, Accounting

Division

Milagros Alvarez

Disbursing Officer

CERTIFIED: Services duly rendered as stated. APPROVED FOR PAYMENT: _________________________________________________________________

_____________________________________________________________________(P )

Lorelli Villaflores

Chief, HR Division

Trinidad A. Rodriguez


Date

CERTIFIED: Supporting documents complete and

proper; and cash available in the amount of P__.

CERTIFIED: Each employee whose name appears on the

payroll has been paid the amount as indicated opposite his/her

name


FORMS AFB – HR Division

Individual Performance and Commitment Review

Prepared by:

LORELLI D. VILLAFLORES Chief, HR Division

Approved by:




TO

: Website Committee

FROM

:

SUBJECT

:

You are hereby directed to:

1. Upload 2. Update 3. Delete/Replace 4. Modify

The following issuances/studies/publications/reports/others:

Remarks:

Requested by:

Chief of Branch

Approved by:



FORMS AFB – IT Unit

Website Form 1

Prepared by:

ABRAHAM P. SOLOMON Computer Maintenance Technologist III

Approved by:




TO

: Website Committee

FROM

:

SUBJECT

:




Remarks:

Requested by:

Chief of Branch

Approved by:

TERESITA L. SOLOMON

Acting Deputy Director


Website Form 2

Prepared by:


Approved by:





TO

: Website Committee

FROM

:

SUBJECT

:




Remarks:

Requested by:

Chief of Branch

Approved by:

NEDINIA B. MENDIOLA

OIC – Planning and Coordinating Branch


Website Form 3

Prepared by:


Approved by:





FORMS AFB – Administrative Division

Petty Cash Voucher

Prepared by:

ELIZABETH MIRIAM L. PAREDES

Chief, Administrative Division

Approved by:



Date : _________________

I. To be filled out upon request II. To be filled out upon liquidation

Requested by:

Approved by:

Paid by:

Cash Received by:


Payee Payee

Date: _______________ Date: _______________

__________________________ __________________________

Name of Requestor

__________________________ __________________________


Name of Immediate Supervisor Petty Cash Custodian

Liquidation Submitted

__________________________

Signature over Printed Name Reimbursement Received by:

Petty Cash Custodian

Received Refund

__________________________

Signature over Printed Name Reimbursement Paid

______________

Amount Refunded/

(Reimbursed)

OR/Invoice No. _______

Total Amount Paid per

Total Amount Granted______________

PETTY CASH VOUCHERNo. : __________________


Fund Cluster: 01

Payee/Office : ____________________________ Responsibility Center Code:

Address : ______________________________________________________

Particulars Amount

A C

B DD


Entity Name: National Tax Research Center Report No:__________________

Fund Cluster: 01 Sheet No.:___________________

Date Petty Cash Particulars

Voucher No.

C E R T I F I C A T I O N

I hereby certify to the correctness of the above information.

________________________________ ____________

Elizabeth Miriam L. Paredes Date

REPORT ON PAID PETTY CASH VOUCHER

Amount


Report on Paid Petty Cash Voucher

Prepared by:

ELIZABETH MIRIAM L. PAREDES Chief, Administrative Division

Approved by:




Fund Cluster: 01

Date

Reference/

Check/

PCV No.

Cash Advance/

Replenishments

Received

Disbursements

Cash

Advance

Balance

Date

PETTY CASH FUND CUSTODIAN

________________

Payee Nature of Payment


I hereby certify that the foregoing is a correct and complete record of all

cash advances received and disbursements made by me in my capacity as Petty

Cash Fund Custodian of________________________ during the period from

_________________ to _______________, inclusive, as indicated in the

corresponding columns.

___________________________________

Elizabeth Miriam L. Paredes

Petty Cash Fund Custodian Official Designation Station


_____________________________________________________________________________________________________


Petty Cash Fund Custodian

Prepared by:



Approved by:




FORMS AFB- Administrative Division

Petty Cash Fund Register

Prepared by:



Approved by:



Department/Agency : National Tax Research Center Petty Cash Fund Custodian : _________________

Sub-Office/District/Division: ______________________________ Fund Cluster : 01

Municipality/City/Province:_______________________________ Sheet No. : ________________________________

PERSONNEL

SERVICES

(+) (-) (50101020) (50201010) (50203010) (50204010) (50204020) (5020502002)

TOTALS - - - - - - - - -

PETTY CASH FUND REGISTER

Telephone

Expenses -

Landline

Date

PCV/

Check

No.

Particulars

PETTY CASH FUND

(10101020)

BREAKDOWN OF PAYMENTS

MAINTENANCE AND OTHER OPERATING

EXPENSES

Receipts

Payments Balance

___________________________________

Elizabeth Miriam L. Paredes

Petty Cash Custodian

Salaries and Wages-

Casual/ Contractual

Traveling

Expenses-

Local

Office

Supplies

Expenses

Water

Expenses

Electricity

Expenses



Stock Card

Prepared by:



Approved by:





Item : Stock No. :

Description : Re-order Point :

Unit of Measurement :

Receipt Balance

Qty. Qty. Office Qty.

STOCK CARD

Date ReferenceIssue No. of Days to

Consume



Inventory Custodian Slip

Prepared by:



Approved by:



Entity Name: National Tax Research Center

Fund Cluster : 01 ICS No : ______________

Received from: Received by:

INVENTORY CUSTODIAN SLIP

Date Date

__________________________________ ______________________________

Position/Office Position/Office

__________________________________ ______________________________

__________________________________ ______________________________

Signature Over Printed Name Signature Over Printed Name

Quantity Unit

Amount

DescriptionInventory

Item No.

Estimated

Useful LifeUnit Cost Total Cost



Purchase Request

Prepared by:



Approved by:





Signature :

Printed Name:

Designation :

PURCHASE REQUEST

Fund Cluster: 01

Office/Section : _____________ PR No.: ______________ Date: ____________

Responsibility Center Code : ______

Stock/

Property No.Unit

Item

DescriptionQuantity

Unit

CostTotal Cost

Purpose: ____________________________________________________________

_______________________________________________________________

_______________________________________________________________

_________________________ ___________________________

Requested by: Approved by:

_________________________ ___________________________

_________________________ ___________________________



Purchase Order

Prepared by:



Approved by:




Supplier : _____________________________________________P.O. No. : ____________________________

Address : _____________________________________________

Gentlemen:

Place of Delivery : ___________________________________

Date of Delivery : ____________________________________

Stock/

Property

No.

Unit Description Quantity Unit Cost Amount

(Total Amount in Words)

Fund Cluster : ___________________________________ORS/BURS No. : ______________________

Funds Available : _________________________________Date of the ORS/BURS: _______________

Amount : ____________________________

PURCHASE ORDER

National Tax Research CenterEntity Name

Date : _______________________________

TIN : ________________________________________________Mode of Procurement : _________________

Please furnish this Office the following articles subject to the terms and conditions contained herein:

Delivery Term : ________________________

Payment Term : ________________________

In case of failure to make the full delivery within the time specified above, a penalty of one-tenth (1/10) of one percent for every day

of delay shall be imposed on the undelivered item/s.

Conforme: Very truly yours,

__________________________ ________________________________

Signature over Printed Name of Supplier Signature over Printed Name of Authorized Official

___________________________ _____________________________

Date Designation

________________________________________

Grace A. Manalo

Chief, Accounting Division



Inspection and Acceptance Report

Prepared by:



Approved by:





IAR No. : _______________

Date : _________________

Invoice No. : ____________

Date : _________________

Stock/

Property No.Unit

INSPECTION AND ACCEPTANCE REPORT

Fund Cluster : 01

Supplier : ______________________________________________

PO No./Date : ___________________________________________

Requisitioning Office/Dept. : _______________________________

Responsibility Center Code : _______________________________

Description Quantity

INSPECTION ACCEPTANCE

Inspection Officer/Inspection Committee Supply and/or Property Custodian

Date Inspected : ________________________ Date Received : _____________________

Inspected, verified and found in order as to quantity and

specifications

Complete

Partial (pls. specify quantity)

____________________________________________ ___________________________________



Requisition and Issue Slip

Prepared by:


Approved by:




Entity Name : National Tax Research Center Fund Cluster : 01

Division : _______________________________________________Responsibility Center Code : ______________________

Office : ________________________________________________RIS No. : _____________________________________

Stock No. Unit Description Quantity Yes No Quantity Remarks

Purpose:

Requested by: Received by:

Signature :

Printed Name :

Designation :

Date :

REQUISITION AND ISSUE SLIP

Requisition Stock Available? Issue

Approved by: Issued by:



Reports of Supplies and Materials Issued

Prepared by:



Approved by:



Entity Name: National Tax Research Center Serial No. : _______________________

Fund Cluster: 01 Date : ___________________________

Posted by:

______________

Date

I hereby certify to the correctness of the above information.

_____________________________________________ __________________________

Signature over Printed Name of Supply and/or

Property Custodian

Signature over Printed

Name of Designated

Accounting Staff

Recapitulation: Recapitulation:

Stock No. Quantity Unit Cost Total Cost UACS Object Code

REPORT OF SUPPLIES AND MATERIALS ISSUED

To be filled up by the Supply and/or Property Division/Unit To be filled up by the Accounting Division/Unit

RIS No.Responsibility Center

Code Stock No. Item Unit

Quantity

IssuedUnit Cost Amount



Waste Materials Report

Prepared by:


Approved by:




Place of Storage : ___________________________________________ Date : ________________________________

No. Date Amount

1

2

3

4

5

6

7

8

9

10

Certified Correct :

I hereby certify that the property enumerated above was disposed of as follows:

Item ________ Destroyed

Item ________ Sold at private sale

Item ________ Sold at public auction

Item ________ Transferred without cost to __(Name of the Agency/Entity)__

Certified Correct: Witness to Disposal:

WASTE MATERIALS REPORT

ITEMS FOR DISPOSAL

Item Quantity Unit Description

Record of Sales

Official Receipt

Signature over Printed Name of

Inspection Officer


Name of Witness

TOTAL

Disposal Approved :

__________________________________


Supply and/or Property Custodian


Head of Agency/Entity or his/her

CERTIFICATE OF INSPECTION


Fund Cluster : 01

(Quantity) (Quantity) Quantity Value

Certified Correct by: Approved by: Verified by:

________________________________ ___________________


of COA Representative

REPORT ON THE PHYSICAL COUNT OF INVENTORIES

Signature over Printed Name of Head of

Agency/Entity or Authorized Representative

For which ___(Name of Accountable Officer )_________, _ (Official Designation )___, National Tax Research Center

Article DescriptionStock

Number

Unit of

Measure

Unit

Value

is accountable, having assumed such accountability on ___(Date of Assumption)____.

Balance Per

Card

On Hand Per

CountShortage/Overage

Remarks

Signature over Printed Name of Inventory

Committee Chair and Members


Report on the Physical Count of Inventories

Prepared by:


Approved by:





Report of Accountability for Accountable Forms

Prepared by:



Approved by:





From To From To From To From To

Inclusive Serial Nos.Quantity

REPORT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS

For the month of ______________________________, 20___

Fund Cluster : 01

Accountable Forms Beginning Balance Receipt Issue Ending Balance

A. WITH FACE VALUE

Name of Form NumberFace

Value Quantity



Inclusive Serial Nos.

B. WITHOUT FACE VALUE

Signature over Printed Name of the Accountable Officer


I hereby certify that the foregoing is a true statement of all accountable forms received,

issued and transferred by me during the period above-stated and that the beginning and ending balances are correct.

_________________________________________________



Property Card

Prepared by:


Approved by:



Entity Name : National Tax Research Center Fund Cluster: 01

Property Number: ____

Receipt Balance

Qty. Qty. Qty.

PROPERTY CARD

Property, Plant and Equipment :

Description :

Date Reference/

PAR No.

Issue/Transfer/ Disposal

Amount Remarks

Office/Officer



Qty.Unit

Cost

Total

Cost

Nature of

RepairAmount

PROPERTY, PLANT AND EQUIPMENT LEDGER CARD

Fund Cluster : 01

Property, Plant and Equipment: Object Account Code: ___________________________________

Estimated Useful Life: __________________________________

Description: Rate of Depreciation: __________________________________

Date Reference

Receipt

Accumulated

Depreciation

Accumulated

Impairment

Losses

Issues/Transfers/

Adjustment/s

Adjusted

Cost

Repair History


Property, Plant and Equipment Ledger Card

Prepared by:


Approved by:






Property Acknowledgment Receipt

Prepared by:



Approved by:




Issued by:

PROPERTY ACKNOWLEDGMENT RECEIPT

Fund Cluster: 01 PAR No.: _________________

Amount

Received by:

_________________________________________ __________________________________________

Signature over Printed Name of End User Signature over Printed Name of Supply

and/or Property Custodian

Quantity Unit DescriptionProperty

Number

Date

Acquired

Date Date

__________________________________ _______________________________

Position/Office Position/Office

_________________________ _________________________



Report on the Physical Count of Property, Plant and Equipment

Prepared by:


Approved by:




Fund Cluster : ________________________________

Q UANTITY per Q UANTITY per

REMARKS

Certified Correct by: Approved by:


Name of Inventory

Committee Chair and

Members

ARTICLE DESCRIPTIONPROPERTY

NUMBER

UNIT OF

MEASUREUNIT VALUE

REPORT ON THE PHYSICAL COUNT OF PROPERTY, PLANT AND EQUIPMENT

________________________________

(Type of Property, Plant and Equipment)

As at ________________________________

For which ___(Name of Accountable Officer )__, _ (Official Designation )___, _______(Entity Name )________ is accountable, having assumed such accountability on _(Date of Assumption) .

SHORTAGE/OVERAGE

Verified by:

_______________________________

Signature over Printed Name of Head of Agency/Entity or

Authorized Representative

Signature over Printed Name of COA

Representative

PHYSICAL CO UNTPRO PERTY CARD



Inventory and Inspection Report of Unserviceable Property

Prepared by:


Approved by:





______________________________

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18)

Requested by: Approved by:

INVENTORY AND INSPECTION REPORT OF UNSERVICEABLE PROPERTY

As at _________________________________

Fund Cluster : 01

______________________________ ______________________________

Date

Acquired

Particulars

/ Articles

Property

No.Qty

Unit

Cost

(Name of Accountable Officer) (Designation) (Station)

INVENTORY INSPECTION and DISPOSAL

Total

Cost

Accumulat

ed

Depreciati

on

Accumulat

ed

Impairment

Losses

Carrying

AmountRemarks

Appraised

Value

RECORD OF SALES

Sale Transfer DestructionOthers

(Specify)Total OR No. Amount

DISPOSAL

(Designation of Accountable Officer) (Designation of Authorized Official)

I HEREBY request inspection and disposition, pursuant to Section 79 of PD 1445, of the property enumerated above.

I CERTIFY that I have inspected each

and every article enumerated in this report,

and that the disposition made thereof was,

in my judgment, the best for the public

interest.

I CERTIFY that I have

witnessed the disposition of the

articles enumerated on this

report this ____day of

_____________, _____.

(Signature over Printed Name of

Inspection Officer)

(Signature over Printed Name

of Witness)

(Signature over Printed Name of Accountable

Officer)

(Signature over Printed Name of

Authorized Official)



Report of Lost, Stolen, Damaged or Destroyed Property

Prepared by:


Approved by:




Police Notified : Yes

No

Status of Property : (check applicable box)

Lost Damaged

Stolen Destroyed

Circumstances:

Noted by:

Government Issued ID : __________________

ID No. : _____________________________

Date Issued : _________________________

Doc. No. _________

Page No. _________

Book No. _________

Series of _________

REPORT OF LOST, STOLEN, DAMAGED OR DESTROYED PROPERTY

Entity Name : National Tax Research Center Fund Cluster: 01

Department/Office : ___________________________________________RLSDDP No. : ______________

Accountable Officer : _________________________________________RLSDDP Date : _____________

Designation : ________________________________________________PAR No. : _________________

Police Station : ____________________PAR Date : ________________

Date : ___________________________

Property No. Description Acquisition Cost

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

Date Date

SUBSCRIBED AND SWORN to before me this ______day of _____________, affiant exhibiting the above

government issued identification card.

Notary Public

I hereby certify that the item/s and circumstances stated

above are true and correct.

__________________________________________ __________________________________

Signature over Printed Name of the Accountable Officer Signature over Printed Name of the Immediate Supervisor

________________ ________________


General Journal

Month ______________


Fund Cluster : 01 Sheet No. : ___________

Date JEV

Particulars UACS

P Amount

No. Object Code Debit Credit

Totals

CERTIFIED CORRECT:

Grace A. Manalo


FORMS AFB – Accounting Division

General Journal

Prepared by:

GRACE A. MANALO Chief, Accounting Division

Approved by:






Cash Receipts Journal

Prepared by:


Approved by:




Fund Cluster : 01

UACS

Object

Code

P Amount

UACS

Object

Code

P Amount

Totals

AO 5-14-02

Recapitulation:

Debit Credit

Certified Correct:

CASH RECEIPTS JOURNAL

SUNDRY

Total

Grace A. Manalo


Account Code PAmount

Month _________________

Sheet No. : __________

Date

RCD/

CRReg

No.

JEV No.

Name of

Collectin

g Officer

COLLECTIONS DEPOSITS

DEBIT

CREDIT DEBIT

CREDIT

SUNDRY



Cash Disbursements Journal

Prepared by:


Approved by:





Fund Cluster : 01 Sheet No. : __________

Account

Title

UACS

Object

Code

P AmountAccount

Title

UACS

Object

Code

P Amount

AO 5-14-02

Recapitulation:

Debit Credit

Total

Certified Correct:


Grace A. Manalo


CASH DISBURSEMENTS JOURNAL

Month _________________

DATE JEV No.RCDisb

No.

Name of

Disbursi

ng

Officer

CREDIT

Office

Supplies

Expenses

(5020301

Transport

ation and

Delivery

Expenses

Fuel, Oil

and

Lubricant

s

DEBIT

SUNDRYAdvances

for

Payroll

(1990102

Advances

for

Operating

Expenses

Advances

to Special

Disbursin

g Officer

SUNDRY Water

Expenses

(5020401

0)



Check Disbursements Journal

Prepared by:


Approved by:





Fund Cluster : 01

From To

UACS

Object

Code

P Amount

UACS

Object

Code

P Amount

Totals

Recapitulation:

Debit Credit

Certified Correct:

SUNDRYSUNDRY

CHECK DISBURSEMENTS JOURNAL

Month __________________

Sheet No. : ______________________

CREDIT DEBIT

Total


DATE JEV No.RCI/DV

No.

Serial No. of

Checks Name of

Disbursi

ng

Officer

Grace A. Manalo



GENERAL LEDGER

Entity Name: National Tax Research Center Fund Cluster : 01

Account Title: ______________________ UACS Object Code: _______

Date Particulars Ref. Amount

Debit Credit Balance

Totals


General Ledger

Prepared by:


Approved by:





SUBSIDIARY LEDGER


Account of: Account Code

Office/Address: GL _____________________

Contact Person: SL _____________________

Contact Number/Email Address:

Date Particulars Ref. Amount

Debit Credit Balance

Totals


Subsidiary Ledger

Prepared by:


Approved by:






Registry of Revenue and Other Receipts - Summary

Prepared by:


Approved by:





Date Reference

UACS

Object

Code

Estimated

Revenue

Revenue

Collections

Non-Revenue

Collections/Oth

er Receipts

Cumulative

Revenue/

Other Receipts

Variance

(Estimated

Revenue over

Cumulative

Revenue and

Other Receipts)

Remittance to

BTr

Deposit

with AGDB/

AABs

Cumulative

Remittances

and Deposits

Unremitted/

Undeposited

Revenue and

Other Receipts

(a) (b) (c) d= (b+c) e= (a-d) (f) (g) h= (f+g) i= (d-h)

REGISTRY OF REVENUE AND OTHER RECEIPTS - SUMMARY

For the year ___________________

Fund Cluster : 01



Registry of Revenue and Other Receipts

Prepared by:


Approved by:





Fund Cluster: Regular Agency/Foreign Assisted Projects Fund Sheet No. : ______________________

Income

Tax

Profession

al Tax

Travel

Tax

Immigratio

n Tax Permit Fees

Registration

Fees

Registration

Plates, Tags

& Sticker

Fees

Clearance

and

Certification

Fees

Franchising

Fees

(40101010) (40101020) (40101030) (40101040) (40201010) (40201020) (40201030) (40201040) (40201050)

(a) (b) (c) (d) (e) (f) (g) (h) (i)=(b+c+d+e+f) (j) (k) (l) (m) (n) (o) (p)=(h+i+j+k+l+m) (q) (q) (r)= (o+p) (s)= (g+n) (t)= (a-q) (u) (v) (w)=(s+t) (x)=(q-u)

REGISTRY OF REVENUE AND OTHER RECEIPTSFor the year ___________________

Date Reference

Estimated Revenue Tax Revenue Collections Non-Tax Revenue Collections Non-Revenue Collections

Cumulati

ve

Revenue

/ Other

Receipts

OriginalAdjustme

ntsFinal Total

Variance

(Estimated

Revenue over

Cumulative

Revenue and

other Receipts)

Remittance to

BTr

Deposit

with

AGDBs/

AABs

Cumulativ

e

Remittanc

es and

Deposits

Unremitted

/

Undeposite

d Revenue

and Other

Receipts

Total

Refunds of

Overpayment

of Expenses

Total



Notice of Budget Utilization Request and Status Adjustment

Prepared by:


Approved by:




NBURSA No. : _______

Date : _____________

Fund Cluster : 01

For: The Budget Officer:

Budget Division/Unit

Please adjust BURS No. ___________________dated _______________

due to the following changes:

Responsibility Center to ___________________________

Particulars to ___________________________

MFO/PAP to ___________________________

Account Code to ___________________________

Amount to P ___________________________

Please adjust RBUD for excess/under obligation per attached

JEV No. ___________dated ____________.

Prepared by: Approved by:

Certified Correct: Verified by:

___________________________ Cecilia V. Salvatierra

Head of the Requesting Division Chief, Budget and Cash Division

NOTICE OF BUDGET UTILIZATION

REQUEST AND STATUS ADJUSTMENT

National Tax Research Center

___________________________ Grace A. Manalo

Accounting Staff-in-Charge Chief, Accounting Division

A. B.

C. D.



Aging of Due and Demandable Obligations

Prepared by:


Approved by:




Number Date Amount

2 3 4 5 6 7 8 9 10 11

Certified Correct by:

Certified Correct by:

Date: ____________

Date: ________ Date: _________________


TOTAL

Recommended by: Approved by:

Grace A. Manalo Trinidad A. Rodriguez

RemarksAmount

90 days &

below

91 to 180

days

181 to 270

days

271 to 360

days

Beyond

360 days

FAR No. 3

AGING OF DUE AND DEMANDABLE OBLIGATIONS

As of December 31, _______

Department: Department of Finance


Operating Units: 01

Chief, Budget and Cash Division

Cecilia V. Salvatierra

Gian Carlo D. Rodriguez

Chief Administrative Officer

Date: _________________

Organization Code (UACS): ___________________________________________

Funding Source Code (as clustered): 01

Name of CreditorObligation Request

AGING OF DUE AND DEMANDABLE OBLIGATIONS

1



Monthly Report of Disbursements

Prepared by:


Approved by:




PS MOOE Fin. Exp CO Sub-Total PS MOOE Fin. Exp CO Sub-Total

2 3 4 5 6= (2+

3+4+5)7 8 9 10

11= (7+

8+9+10)12 13 14 15

16=

(12+

13+14+1

5)

17=(11+16)18=(6+17) 19 20 2122=(19+

20+21)23 24 25 26

27=(23+2

4+25+26)28

Notice of Cash Allocation (NCA)

MDS Checks Issued

Advice to Debit Account

Working Fund (NCA issued to BTr)

Tax Remittance Advices Issued (TRA)

Cash Disbursement Ceiling (CDC)

Non-Cash Availment Authority (NCAA)

Others (CDT, BTr Docs Stamp, etc.)

TOTAL


Tax Remittance Advices Issued

Cash Disbursement Ceiling

Non-Cash Availment Authority

Others (CDT, Docs Stamp, etc.)

TOTAL






TOTAL






SUMMARY:

As of Date

Total Disbursement Authorities Received

NCA Less: * Actual Disbursements

Working Fund

TRA

CDC

NCAA

Others (CDT, BTr Docs Stamp, etc.)

Less: Notice of Transfer Allocations (NTA)* issued

Total Disbursements Authorities Available

Less: Lapsed NCA

Disbursements *

Balance of Disbursements Authorities as of to date

Notes: The use of NTA is discouraged

* Amounts should tally

Certified Correct: Approved By:

Operating Unit: 01

FAR No. 4

MONTHLY REPORT OF DISBURSEMENTS

For the month of ______, 20___Department: Department of Finance


Organization Code (UACS): __________________________________


PARTICULARS

CURRENT YEAR BUDGET PRIOR YEAR'S BUDGET

TOTAL

TRUST LIABILITIES GRAND TOTAL

RemarksPS MOOE Fin. Exp CO TOTAL

PRIOR YEAR'S ACCOUNTS PAYABLE CURRENT YEAR'S ACCOUNTS PAYABLE

SUB-

TOTA

L

Notice of Cash Allocation

Fin. Exp CO TOTAL

1

FEBRUARY


PS MOOE CO TOTAL PS MOOE

MDS Checks Issued

MARCH


MDS Checks Issued

1ST QUARTER

MDS Checks Issued

GRAND TOTAL

Previous Report (Feb) This month (March) This month (March) As of Date

Total Disbursements Program

(Over)/Under spending

Grace A. Manalo Trinidad A. Rodriguez


Date: ____________________________ Date: ____________________________

Previous Report (Feb)



Quarterly Report of Revenue and Other Receipts

Prepared by:


Approved by:




1st Quarter 2nd Quarter 3rd Quarter 4th Quarter TOTALRemittance to

BTr

Deposited

with AGDBTotal Amount %

2 3 4 5 6 7 8=(4+5+6+7) 9 10 11=(9+10) 12=(8-3) 13 = (12 / 3) 14

A. General Fund (formerly Fund 101)

- Tax

Documentary Stamp Tax 40104010 00

- Non-Tax

Permit Fees Import 40201010 01

B. Special Account in the

General Fund (formerly Fund 105, 183, 401, 151-159)

- Tax

- Non-Tax

C. Off-Budget Accounts (formerly Fund 161 to 164, etc.)

D. Custodial Funds (formerly Fund 101-184, 187)

TOTAL

Certified Correct: Approved By:


Grace A. Manalo

FAR No. 5

QUARTERLY REPORT OF REVENUE AND OTHER RECEIPTSAs of the Quarter Ending _____________

(In Pesos)


Operating Unit: 01

Organization Code (UACS): ___________________________________

CLASSIFICATION / SOURCES

OF REVENUE AND OTHER RECEIPTSUACS Code

REVENUE

TARGET

(Annual)

VARIANCE

Remarks

1


ACTUAL REVENUE AND OTHER RECEIPTS/COLLECTIONS


Date: ______________________________________ Date: __________________

CUMULATIVE REMITTANCE

/DEPOSITS TO DATE



Order of Payment

Prepared by:


Approved by:




Total

Entity Name : National Tax Research Center Serial No. : _______________

Fund Cluster : 01 Date : __________________

ORDER OF PAYMENT

The Collecting Officer

Budget and Cash Division

Please issue Official Receipt in favor of

(Name of Payor)

P

(Address/Office of Payor)

in the amount of _____________________________________(P_____________)

for payment of

(Purpose)

per Bill No. ________________ dated __________________.

Please deposit the collections under Bank Account/s:

No. Name of Bank Amount

P

Grace A. Manalo



Notice of Obligation Request and Status Adjustment Serial No. : _________

National Tax Research Center Date : _____________

Fund Cluster : ______

For: The Budget Officer:

Budget Division/Unit

Please adjust ORS No. __________dated _______

due to the following changes:

Responsibility Center to ___________________________

Particulars to ___________________________

MFO/PAP to ___________________________

Account Code to ___________________________

Amount to P ___________________________

Please adjust RAOD for excess/under obligation per

attached JEV No. _______dated _____.

Prepared by: Approved by:

____________________________

Accounting Staff-in-Charge Grace A. Manalo


Certified Correct:

Verified by:

_____________________________ Cecilia V. Salvatierra

Head of Requesting Office/ Chief, Budget and Cash Division

Authorized Representative


Notice of Obligation Request and Status Adjustment

Prepared by:


Approved by:






Journal Entry Voucher

Prepared by:


Approved by:




TOTAL

Prepared by: Certified Correct:

Administrative Officer III Chief, Accounting Division

Angelito L. Olaes Grace A. Manalo


Fund Cluster : 01

_______________________________ __________________________________

JOURNAL ENTRY VOUCHER JEV No.:________

Date :

Responsibility

Center

ACCOUNTING ENTRIES

Accounts and Explanation

UACS

Object

Code

Amount

Debit Credit


FORMS

AFB – Accounting Division

Advice to Debit Account Disbursements Journal

Prepared by:


Approved by:



DATE J E V RADAI

No. No. From To

UACS

Object

Code

P Amount

UACS

Object

Code

P Amount

Totals

Debit Credit

Total

Certified Correct:

ADVICE TO DEBIT ACCOUNT DISBURSEMENTS JOURNAL


S U N D R Y

Recapitulation:

Account

CodeP

Amount

Grace A. Manalo


Fund Cluster : 01 Sheet No. : ____________________

LDDAP-

ADA No.Name of

Disbursing

Officer/

Cashier

C R E D I T D E B I T

S UND R Y



Index of Payments

Prepared by:


Approved by:




INDEX OF PAYMENTS


Creditor: _________________________________Address: _____________________________________Employee No.: _________________

TIN: _________________________

DateReference/DV/

Payroll No.Particulars

Check/LDDAP-ADA AMOUNT

Date No.Gross

Amount

Deductions Net

Amount

________________________________



Cash Disbursements Record

Prepared by:


Approved by:





Fund Cluster : 01

Milagros Alvarez

________________

Date


I hereby certify on my official oath that the foregoing is a correct and complete record of all

cash disbursements had by me in my capacity as ______(Designation)____ of National Tax

Research Center during the period from _______________ to _______________,inclusive, as

indicated in the corresponding columns.

_______________________________

Accountable Officer Disbursing Officer

Date

ADA/Check/

DV/Payroll/

Reference

No.

Payee

UACS

Object

Code

Nature of Payment

Cash

Advance

Received/

(Refunded)

Disbursements

Cash

Advance

Balance

Sheet No. : _________________

Milagros Alvarez ________________________________ ________________

Station



Report of Cash Disbursements

Prepared by:


Approved by:


Executive Director


Entity Name : National Tax Research Center Report No. : ______________________

Fund Cluster : 02 Sheet No. : _______________________

______________

Official Designation Date

REPORT OF CASH DISBURSEMENTS

Rita B. Par

UACS Object Code Nature of Payment Amount

CERTIFICATION

I hereby certify on my official oath that this Report of Cash Disbursements

in _________ sheet(s) is a full, true and correct statement of all cash

disbursements during the period stated above actually made by me in payment for

obligations shown in pertinent disbursement vouchers/payroll.

DateDV/Payroll

No.

ORS/BURS

No.

Responsibility

Center CodePayee


Serial No.: _________________

Date: _____________________

Responsibility Center Code:

__________________________

A Certified: Correctness of the Certified: Purpose of travel /

above data cash advance duly accomplished

________________________ ________________________ ________________________

Signature over Printed Name Signature over Printed Name Grace A. Manalo

Claimant Immediate Supervisor Chief, Accounting Division

JEV No.: ___________________

Date: ______________________Date: _____________________ Date: _____________________

AMOUNT OF CASH ADVANCE PER DV NO.______DTD. ______

AMOUNT REFUNDED PER OR NO. ________DTD. ___________

AMOUNT TO BE REIMBURSED

Certified: Supporting documents

complete and proper

TOTAL AMOUNT SPENT

LIQUIDATION REPORT


Fund Cluster : 01

PARTICULARS AMOUNT

B C


Liquidation Report

Prepared by:


Approved by:






Schedule of Accounts Payable

Prepared by:


Approved by:




Fund Cluster: 01 UACS Object Code : ______________

less than 91-365 Over Over Over 3 years

90 days days 1 year 2 years and onwards

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

Certified Correct :

Grace A. Manalo


SCHEDULE OF ACCOUNTS PAYABLE

No.

Name of Creditor

(in alphabetical

order)

Amount

Balance

Amount Due

RemarksCurrent Past Due


less than 91-365 Over Over Over 3 years

90 days days 1 year 2 years and onwards

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

Certified Correct :

SCHEDULE OF ACCOUNTS RECEIVABLE


Fund Cluster: 01 UACS Object Code : ______________

No.

Name of Debtor

(in alphabetical

order)

Amount

Balance

Amount Due

RemarksCurrent Past Due

Grace A. Manalo



Schedule of Accounts Receivable

Prepared by:


Approved by:





Registry of Accounts Written Off

Prepared by:


Approved by:



Date No.Amount

REGISTRY OF ACCOUNTS WRITTEN OFF

Account Title :___________________________________ Fund Cluster : 01

UACS Object Code :______________________________ Sheet No. : ________________

ReferenceParticulars

Reason for

Write-offAuthority

No. of Years

Uncollected




Supplies Ledger Card

Prepared by:


Approved by:




Item : Item Code :

Description : Re-order Point :

Unit of Measurement :

SUPPLIES LEDGER CARD

Fund Cluster : 01

Date Reference

Receipt Issue Balance No. of

Days to

ConsumeQty.

Unit

CostTotal CostQty.

Unit

CostTotal Cost Qty.

Unit

CostTotal Cost


Particulars Agency Bank Explanatory Comment

Unadjusted Balances xxx xxx

Add/Deduct: Bank

Reconcilng Items

1. Unrecorded NCA xxx See Schedule ___

2. Errors which understates the

bank balance xxx

3. Lapsed NCA (xxx)

4. Outstanding Checks (xxx) See Schedule ___

5. Errors which overstates the

bank balance (xxx)

Add/Deduct: Agency Book

Reconcilng Items

1. Unrecorded NCA xxx NCA No. ____

2. Cancelled Checks xxx See Schedule ___


book balance xxx CM No. ____

4. Lapsed NCA (xxx) See Schedule ___


book balance (xxx) DM No. ____

6. Bank Charges (xxx) DM No. ____

Adjusted Balances xxx xxx

Name of the Agency

Cash - MDS, Regular

Monthly Reconciliation Statement

As of ____________________

Fund Cluster: 01


Bank Reconciliation Statement, Cash – MDS

Prepared by:


Approved by:





Particulars Agency Bank Explanatory Comment

Unadjusted Balances xxx xxx

Add/Deduct: Bank

Reconcilng Items

1. Unrecorded NCA xxx See Schedule ___


bank balance xxx

3. Lapsed NCA (xxx)

4. Outstanding Checks (xxx) See Schedule ___


bank balance (xxx)

Add/Deduct: Agency Book

Reconcilng Items

1. Unrecorded NCA xxx NCA No. ____

2. Cancelled Checks xxx See Schedule ___


book balance xxx CM No. ____

4. Lapsed NCA (xxx) See Schedule ___


book balance (xxx) DM No. ____

6. Bank Charges (xxx) DM No. ____

Adjusted Balances xxx xxx

Name of the Agency

Cash - Local Currency Savings Account

Monthly Reconciliation Statement

As of ____________________

Fund Cluster: 01


Bank Reconciliation Statement, Cash – Local Currency Savings Account

Prepared by:


Approved by:





FORMS AFB – Budget and Cash Division

Obligation Request and Status

Prepared by:

CECILIA V. SALVATIERRA Chief, Budget and Cash Division

Approved by:




Certified: Allotment available and obligated

for the purpose/adjustment necessary as

supporting documents valid, proper and legal indicated above

Signature : _________________

Printed Name: _________________

Position : Cecilia Salvatierra

Date : ______________

C.

Not Yet DueDue and

Demandable

(a) (c) (a-b) (b-c)

Balance

(b)

Date ParticularsORS/JEV/Check/

ADA/TRA No.

Obligation Payable Payment

Chief, Budget and Cash Division

Date : ___________________________________

STATUS OF OBLIGATION

Reference Amount

Signature : ___________________________________

Printed Name: ____________________________________

Position : ____________________________________

Head, Requesting Office/Authorized Representative

A.Charges to appropriation/alloment are

B.Certified:

necessary, lawful and under my direct supervision;and

Responsibility Center Particulars MFO/PAPUACS Object

CodeAmount

Payee

Office

Address

OBLIGATION REQUEST AND STATUS Serial No. :

National Tax Research Center Date : _________________________

Fund Cluster : 01



Summary of LDDAP-ADAs Issued and Invalidated ADA Entries

Prepared by:


Approved by:




To: The Bank Manager

(Bank Branch)

(Address)

PS MOOE CO FE

No. of pcs of LDDAP-ADA _____________

PS MOOE CO FE TOTAL

Certified Correct by: Approved by:

Chief, Budget and Cash Division Head of Agency/Authorized Official

(Signature) (Signature)

Cecilia V. Salvatierra (Name in Print)

Total Amount

LDDAP-ADA No. AmountDate

Issued

OF WHICH INVALIDATED ENTRIES OF PREVIOUSLY ISSUED LDDAP-ADAs

Allotment/Object Class

Remarks

LDDAP-ADA No.Date of

Issue

Amount For GSB Use Only

TotalAllotment/Object Class

Remarks

Operating Unit: ______________________________ Date : _____________________________

Fund Cluster: 01

Entity Name: National Tax Research Center SLIIAE No.: _________________________



Report of Advice to Debit Account Issued

Prepared by:


Approved by:





Date Serial No.

Bank Name/Account No. : __________________________________ Sheet No.: ____________________________

REPORT OF ADVICE TO DEBIT ACCOUNT ISSUED

Period Covered: ________________

Fund Cluster : 01 Report No.: ____________________________

Rita B. Par

ADA DV/Payroll

No.

ORS/BURS

No.

Responsibility

Center CodePayee

UACS

Object CodeNature of Payment Amount

CERTIFICATION

I hereby certify on my official oath that the above is a true statement of all ADAs issued by me during

the period stated above for which ADA Nos. ____________ to ___________ inclusive, were actually issued by me in the amounts shown thereon.

Cashier

________________________________ ________________________

Official Designation Date



Budget Utilization Request and Status

Prepared by:


Approved by:




Certified: Budget available and utilized for

lawful and under my direct supervision; and supporting the purpose/adjustment necessary as

documents valid, proper and legal indicated above

Signature : ___________________

Printed Name: ______________

Position : Cecilia V. Salvatierra

Date : ____________________________

C.

Not Yet Due

Due and

Demanda

ble

(a) (c) (a-b) (b-c)

BUDGET UTILIZATION REQUEST AND STATUS Serial No. : ___________________

Date : _______________________

National Tax Research Center Fund Cluster : 01

Payee

Office

Address

Responsibility Center Particulars MFO/PAPUACS Object

Code/ Amount

Total

A. B.Certified: Charges to appropriation/budget necessary,

Reference Amount

Signature : ____________________________________

Printed Name: ____________________________________

Position : ____________________________________

Head, Requesting Office/Authorized Representative Chief, Budget and Cash Division

Date : _______________________________

STATUS OF UTILIZATION

Balance

(b)

Date ParticularsBURS/JEV/RCI/

RADAI/RTRAI No.

Utilization Payable Payment



Statement of Appropriations, Allotments, Obligations, Disbursements and Balances

Prepared by:


Approved by:




(e.g. Old Fund Code: 101,102, 151)

2 3 4 5=(3+4) 6 7 8 9 10=[{6+(-)7}-8+9] 11 12 13 14 15=(11+12+13+14) 16 17 18 19 20=(16+17+18+19) 21=(5-10) 22=(10-15) 23 24

II. Automatic Appropriations

RLIP 1 04 102

CSpecial Account in the General Fund (Please specify)

Motor Vehicle Users Charge Fund `

MOOE

CO

Sub-Total, Automatic Appropriations

PS

MOOE

Fin Exp.(if applicable)

CO

III. Special Purpose Fund (Please specify)

MPBF-PS 1 01 406

PGF-PS (Pension Benefits) 1 01 407

Sub-Total, Special Purpose Fund

PS

MOOE


CO

GRAND TOTAL

PS

MOOE


CO

Recapitulation by MFO:

MFO 1

MFO 2


OF WHICH:


KRA No. 1 - Anti-Corruption, Transparent,

Accountable and Participatory Governance

Program Budgeting:

MPP


and monitored by the President through

PMS

PAP




Certified Correct: Recommending Approval: Approved By:


Date: ____________________________________ Date: ____________________________________ Date: _________________________________ Date: _____________________________

Chief, Budget and Cash Division Chief, Accounting Division Chief Administrative Officer Acting Executive Director

Unreleased

Appropriations

Unobligated

Allotment

Authorized

Appropriation

Adjustments

(Transfer

To)/From,

Realignment)

Adjusted

Appropriations

Allotments

Received

Adjustments

(Withdrawal,

Realignment)

Transfer

To

Certified Correct:

Cecilia V. Salvatierra Grace A. Manalo Gian Carlo D. Rodriguez

1

Total1st Quarter

Ending March

31

2nd Quarter

Ending June

30

3rd Quarter

Ending Sept.

30

Transfer

From

Adjusted Total

Allotments

1st Quarter

Ending March

31

2nd Quarter

Ending June

30

3rd Quarter

Ending Sept. 30

4th Quarter

Ending Dec.

31

Current Year Disbursements Balances

Unpaid Obligations

Due and

Demandable

Not Yet Due and

Demandable

4th Quarter

Ending Dec.

31

TotalParticulars

UACS

CODE

Appropriations Allotments Current Year Obligations

STATEMENT OF APPROPRIATIONS, ALLOTMENTS, OBLIGATIONS, DISBURSEMENTS AND BALANCES

As of the Quarter Ending _______________

Funding Source Code (as clustered): 01 Supplemental Appropriations



Department : Department of Finance


Operating Unit : 01

Organization Code (UACS) : _____________________________________________


FORMS AFB – Budget and Cash Division – Statement of Appropriations, Allotments,

Obligations, Disbursements and Balances by Object of Expenditures

Prepared by:


Approved by:




1 2 3 4 5=(3+4) 6 7 8 9 10=[{6+(-)7}-8+9] 11 12 13 1415=(11+12+13+1

4)16 17 18 19

20=(16+17+18+19

)21=(5-10) 22=(10-15) 23 24

Financial Expenses

Capital Outlays

Property, Plant and Equipment Outlay50604040 00

50604040 01

50604040 02

50604040 03

50604040 04

50604050 00

50604050 01

50604050 02

50604050 03

B. AUTOMATIC APPROPRIATIONS

Retirement and Life Insurance Premium

Customs Duties and Taxes

C. SPECIAL PURPOSE FUNDS

Miscellaneous Personnel Benefits Fund

Pension and Gratuity Fund

GRAND TOTAL

Certified Correct: Recommending Approval: Approved By:

Unreleased

Appropriatio

ns

Unobligated

Allotment

Date: _________________________ Date: _________________________ Date: _________________________

Grace A. Manalo Gian Carlo D. Rodriguez Trinidad A. Rodriguez

Chief, Accounting Division Chief Administrative Officer Acting Executive Director

Transfer

To

Transfer

From

Adjusted

Total

Allotments

1st Quarter

Ending

'March 31

Unpaid Obligations

Due and

Demandable

Not Yet Due

and

Demandable

2nd Quarter

Ending

'June 30

3rd Quarter

Ending

'Sept. 30

4th Quarter

Ending 'Dec.

31

Total

1st Quarter

Ending 'March

31

2nd Quarter

Ending 'June

30

3rd Quarter

Ending 'Sept.

30

4th Quarter

Ending 'Dec.

31

Total

Organization Code (UACS): ________________________________________________________________________________ Supplemental Appropriations

Funding Source Code (as clustered) : _________________________________________________________________________ Continuing Appropriations

ParticularsUACS

CODE

Appropriations Allotments Current Year Obligations Current Year Disbursements Balances

Authorized

Appropriation

Adjustments

(Transfer

(To)/From,

Realignment)

Adjusted

Appropriati

ons

Allotments

Received

Adjustments

(Withdrawal,

Realignment)

SUMMARY OF APPROPRIATIONS, ALLOTMENTS, OBLIGATIONS, DISBURSEMENTS AND BALANCES BY OBJECT OF EXPENDITURES

As of the Quarter Ending _______________________________________________



Operating Unit: 01 Current Year Appropriations



List of Allotments and Sub-Allotments

Prepared by:


Approved by:






Supplemental Appropriations

Number Date DescriptionUACS Code PS MOOE CO Total PS MOOE CO Total PS MOOE CO Total

1 2 3 4 5 6 7 8 9=(6+7+8) 10 11 12 13=(10+11+12) 14 = (6+10) 15 = (7+11) 16 = (8 + 12) 17=(14+15+16)

1

Comprehensive Release per

Annex A and

A-1 of NBC No. 551 2-Jan-14

Agency

Specific

Budget 1 01 101

2 GARO No. 2014-1 (RLIP) 2-Jan-14 RLIP 1 04 102

3

4 SARO (MPBF) 1 01 406

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

Sub-total - - - - - - - - - - - -

1

2

3

4

5

6

Sub-Total - - - - - - - - - - - -

Total Allotments - - - - - - - - - - - -

Summary by Funding Source Code:

1 01 101

1 04 102

1 01 406

Sub-Allotment to Regions/Operating Units Total Allotments / Net of Sub-allotments

A. Allotments received from DBM

B. Sub-allotments received from

Central Office/Regional Office

Agency Specific

RLIP

MPBF

Organization Code (UACS): _______________________________________________________________

Funding Source Code (as clustered) : ________________________________________________________

No. Allotments / Sub-Allotments Funding Source Allotments / Sub-Allotments

Operating Unit: 01

FAR No. 1-B

List of Allotments and Sub-Allotments

As of the quarter ending ___________, 20___





Statement of Approved Budget, Utilizations, Disbursements and Balances

Prepared by:


Approved by:




2 3 4 5=[3+(-)4] 6 7 8 910=(6+7+8+9

)11 12 13 14

15=(11+12

+13+14)16=(5-10) 17 18

I. Agency Approved Budget

General Administration and Support

General Administration and Supervision

PAP

PS

PS

MOOE


CO

Support to Operations

PAP

PS

PS

PS MOOE

MOOE Fin Exp.(if applicable)

Fin Exp.(if

applicable) CO

CO Operations

MFO 1 - [MFO Description]

PAP

PS

PS

MOOE

PS Fin Exp.(if applicable)

MOOE CO



PS Locally-Funded Project(s)

MOOE PAP

Fin Exp.(if

applicable) PS

CO MOOE

… Fin Exp.(if applicable)

CO


PS Foreign-Assisted Project(s)

MOOE PAP

Fin Exp.(if

applicable) PS

CO MOOE

… Fin Exp.(if applicable)

CO


Sub-Total, Agency Specific Budget

PS

MOOE


CO

II. Automatic Appropriations

RLIP

CO Special Account in the General Fund (Please specify)

Motor Vehicle Users Charge Fund

MOOE

CO

Sub-Total, Automatic Appropriations

PS

MOOE


CO

III. Special Purpose Fund (Please specify)

MPBF-PS

PGF-PS (Pension Benefits)

Sub-Total, Special Purpose Fund

PS

MOOE


CO

GRAND TOTAL

PS

PS

MOOE


CO

Recapitulation by MFO:

MFO 1

MFO 2


OF WHICH:


KRA No. 1 - Anti-Corruption, Transparent, Accountable

and Participatory Governance

Program Budgeting:

MPP


and monitored by the President through PMS

PAP




3rd Quarter

Ending 'Sept.

30

4th Quarter

Ending 'Dec.

31

TotalUnutilized

Budget

Date: ___________________________ Date: ___________________________ Date: ___________________________ Date: ___________________________

Cecilia V. Salvatierra Grace A. Manalo Gian Carlo D. Rodriguez Trinidad A. Rodriguez


1

Certified Correct: Certified Correct: Recommending Approval: Approved By:

Disbursements BALANCES

Approved

Budgeted

Revenue

Adjustments

(Additions,

Reductions,

Realignment)

Adjusted

Budgeted

Revenue

1st Quarter

Ending 'March

31

2nd Quarter

Ending 'June

30

3rd Quarter

Ending 'Sept.

30

4th Quarter

Ending 'Dec.

31

Total

Budget Utilization

Unpaid Utilizations

Due and

Demandable /

Accounts Payable

Not

Yet

Due

and

1st Quarter

Ending

'March 31

2nd Quarter

Ending 'June

30

Organization Code (UACS): ________________________________________

Funding Source Code (as clustered) : ________________________________

ParticularsUACS

CODE

Approved Budget

Operating Unit: 01

FAR No. 2

STATEMENT OF APPROVED BUDGET, UTILIZATIONS, DISBURSEMENTS AND BALANCESAs of the Quarter Ending _________________




FORMS AFB – Budget and Cash Division – Summary of Approved Budget,

Utilizations, Disbursements and Balances by Object of Expenditures

Prepared by:


Approved by:




2 3 4 5=[3+(-)4] 6 7 8 910=(6+7+

8+9)11 12 13 14

15=(11+12+13

+14)16=(5-10) 17 18

Financial Expenses

Management Supervision/Trusteeship Fees

Interest Expenses

Interest Paid to Non Residents

Interest Paid to Residents other than General Government

Interest Paid to other General Government Units

Continue down to the last object of expenditure…

Capital Outlays

Property, Plant and Equipment Outlay

Buildings and Other Structures Outlay 50604040 00

Buildings 50604040 01

School Buildings 50604040 02

Hospitals and Health Centers 50604040 03

Markets 50604040 04

Machinery and Equipment Outlay 50604050 00

Machinery 50604050 01

Office Equipment 50604050 02

Information and Communication Technology Equipment 50604050 03

(sample object of expenditure only)

Continue down to the last object of expenditure…

GRAND TOTAL

Certified Correct: Certified Correct:

Date: ________________________________ Date: __________________________ Date: __________________________ Date: __________________________

Cecilia V. Salvatierra Grace A. Manalo Gian Carlo D. Rodriguez Trinidad A. Rodriguez


1

Recommending Approval: Approved By:

1st Quarter

Ending

'March 31

2nd Quarter

Ending

'June 30

3rd Quarter

Ending

'Sept. 30

4th Quarter

Ending

'Dec. 31

Disbursements BALANCES

Approved

Budgeted

Revenue

Adjustments

(Additions,

Reductions,

Realignment)

Adjusted

Budgeted

Revenue

1st Quarter

Ending

'March 31

2nd Quarter

Ending

'June 30

3rd Quarter

Ending

'Sept. 30

4th Quarter

Ending

'Dec. 31

Total

Budget Utilization

Unpaid Utilizations

(10-15) = (17+18)

Due and

Demandable

/ Accounts

Payable

Not Yet

Due and

Demandable

TotalUnutilized

Budget

Organization Code (UACS): ____________________________________________


Particulars UACS CODE

Approved Budget

Operating Unit: 01

FAR No. 2-A

SUMMARY OF APPROVED BUDGET, UTILIZATIONS, DISBURSEMENTS AND BALANCES BY OBJECT OF EXPENDITURES

As of the Quarter Ending _______________




NOTICE OF DISHONORED CHECKS

_______________________

_______________________

_______________________

Sir/Madam:

You are hereby notified that your (name of bank) Check No. _________ dated

__________, 20__, in the amount of P__________ paid to us and acknowledged by our Official

Receipt No. __________ dated ___________, 20__ has been deposited but was dishonored

and returned to us due to __________________________.

In view thereof, we have, today, reversed the payment recorded and reinstated your

liability in the same manner as if you had never tendered any payment.

Please settle your account in cash or by certified check to the undersigned within five

days from receipt of this notice. Otherwise, we will be constrained to institute criminal action

against you as may be warranted under Article 315 of the Revised Penal Code and Batas

Pambansa Blg. 22.

Very truly yours,



By:

_______________________

(Collecting Officer)

Note: The last paragraph applies only to cases where the cause of the dishonor of the check is lack or

insufficiency of funds. Where the check is dishonored by reason of defect in form, such as

incomplete signature or the like, the following paragraph should be used in lieu of the

aforementioned last paragraph.

Please settle your account in cash or by certified check to the undersigned

within three days from receipt of this notice. Otherwise, we will be constrained

to initiate appropriate action to enforce our claim.


Notice of Dishonored Checks

Prepared by:


Approved by:






Report of Collections and Deposits

Prepared by:


Approved by:




Report No. : ______________________

Entity Name : National Tax Research Center Sheet No. : _______________________

Fund Cluster : 01 Date : ___________________________

Taxes Fees

Date Number 40101010 40201010

Total

Summary:

Undeposited Collections per last Report

Deposits

Date: ________________ P xxx.xx

Date: ________________ xxx.xx

Undeposited Collections, this Report

_________________________

Collecting Officer Date

Milagros Alvarez

REPORT OF COLLECTIONS AND DEPOSITS

Official Receipt/ Report

of Collections by Sub-

Collector

Responsibility

Center CodePayor Particulars MFO/PAP

Amount

Total per

OR

Breakdown of Collections

Collections per OR Nos. __________to____________

CERTIFICATION

I hereby certify on my official oath that

the above is a true statement of all collections

and deposits had by me during the period stated

above for which Official Receipt Nos.

____________ to ___________ inclusive,

were actually issued by me in the amounts

shown thereon. I also certify that I have not

P xxx.xxxxx.xx

xxx.xxP xxx.xx



Cash Receipts Register

Prepared by:


Approved by:




Entity Name : National Tax Research Center Name of Collecting Officer/Cashier : Milagros Alvarez

Sub-Office/District/Division : ______________________________ Fund Cluster : 01

Municipality/City/Province : ______________________________ Sheet No. : ____

Date : __________

National

Treasury AGDB

(+) (-) (-) (=) (40201010) (40201020) (40201040) (40201140)

TOTALS - - - - - - - 0

CERTIFIED CORRECT:

Official Receipt/

Deposit Slip

Payor

Cash - Collecting Officer

(10101010)

BREAKDOWN OF RECEIPTS

Permit

Fees

CASH RECEIPTS REGISTER

Date Number Receipts

Deposits

Balance

Date

Registration

Fess

Clearance

and

Certification

Fees

Fines and

Penalties -

Service

Income

OTHERS

Account

Description

UACS

Object

Code

Amount

Milagros Alvarez

___________________



Cash Receipts Record

Prepared by:


Approved by:




MFO/PAPObject

Code

Milagros Alvarez

Date

DepositUndeposited

Collection


I hereby certify on my official oath that the foregoing is a correct and complete record

of all collections and deposits had by me in my capacity as Collecting Officer of

National Tax Research Center during the period from _________________ to

Date

Reference

No./OR

No./DS

Payor

UACS Code Nature

of CollectionCollection

_______________, inclusives, as indicated in the corresponding columns.

_______________________ _____________________________ ______________

Accountable Officer Official Designation Station

CASH RECEIPTS RECORD

Entity Name : National Tax Research Center Sheet No. : _________________

Fund Cluster : 01 Year : _____________________


REGISTRY OF ALLOTMENTS AND NOTICE OF ALLOCATION

Entity Name (RO/OU) : National Tax Research Center Fund Cluster : 01

Sheet Number : _____________

Date Reference

AMOUNT

Allotment

Received

Notice of Transfer of

Allocation Balance

Received Utilized Unutilized

NTA Unfunded Allotment

(a) (b) ( c) (b - c) (a - b)


Registry of Allotments and Notice of Transfer of Allocation

Prepared by:


Approved by:






Checks and Advice to Debit Account Disbursement Record

Prepared by:


Approved by:





Bank Name/Bank Account Number : _____________________

Check ADA

CHECKS AND ADVICE TO DEBIT ACCOUNT DISBURSEMENT RECORD

Fund Cluster : 01

Sheet No. : _____________________

________________________________________________ __________________________________________________

Accountable Officer Official Designation Station

NCA/DS/DV/Payr Check/ADA

Payee

UACS

Object

Code

Nature

of

Payment

Amount

No.

________________

Date

ADA

Issued

NCA/Bank

Balance


I hereby certify on my official oath that the foregoing is a correct and complete record of all checks/ADAs issued by me in my capacity as

_____________________________ of National Tax Research Center

(Designation) (Name of Agency)

during the period from _______________ to _______________, inclusive, as indicated in the corresponding columns.

___________________________

Rita B. Par

Date

Serial No.

DateDate

Released

NCA

Received/

Deposit

Made

Check

Issued



Report of Checks Issued

Prepared by:

CECILIA V. SALVATIERRA Chief, Cash and Busget Division

Approved by:





Fund Cluster : 01 Report No.: __________

Bank Name/Account No. : __________________________________ Sheet No.: ___________

Date Serial No.

______________

Date

REPORT OF CHECKS ISSUED

Rita B. Par

CheckDV/Payroll

No.

ORS/BURS

No.

Responsibility

Center CodePayee

UACS

Object

Code

Nature of Payment Amount


I hereby certify on my official oath that this Report of Checks Issued in _________ sheet(s) is a full, true and correct

statement of all checks issued by me during the period stated above for which Check Nos. ___ to ____ inclusive,

were actually issued by me in payment for obligations shown in the attached disbursement vouchers/payroll.

____________________________________________



Cash in Bank Register

Prepared by:


Approved by:




Sheet No.: ____________________________________

Name of Disbursing Officer: Milagros Alvarez

Station: ______________________________________

Bank : _______________________________________

Location: _____________________________________

(50101020) (50201010) (50203010) (50201010) (50299040) (50212020)

TOTALS - - - - - - - - -

Certified Correct:

CASH IN BANK REGISTER

Date Check No.


Particulars

CASH IN BANK BREAKDOWN OF WITHDRAWALS/PAYMENTS

PERSONNEL SERVICES MAINTENANCE AND OTHER OPERATING EXPENSES OTHERS

Deposits

Withdrawals/

Payments

Balance

Salaries and

Wages-

Casual

Travelling

Expenses-

Local

Office

Supplies

Expenses

Electricity

Expenses

Municipality/City/Province:_________________________________

Fund Cluster : 01

Sub-Office/District/Division: ________________________________

Amount

Milagros Alvarez

Disbursing Officer

Transportati

on and

Delivery

Expenses

Janitorial

Services Account

Description

UACS

Code



Advice of Checks Issued and Cancelled

Prepared by:


Approved by:



To: The Bank Manager ACIC No. :

___________________ Bank Account No. ______________ Organization Code :

___________________ Fund Cluster : 01

Date _________________________ Area Code :

NCA No. :

DATE OF

ISSUE DATE NEGT'D. REMARKS

Total ACIC Amount

Total number of checks: ___________ Amount in words __________________________________________________

ADVICE OF CHECKS ISSUED AND CANCELLED

National Tax Research Center

CHECK NO. PAYEE AMOUNT

UACS

OBJECT

CODE

FOR GSB USE ONLY



Advice of Checks Issued and Cancelled

Prepared by:


Approved by:




Certified Correct By: Received by:

Check No. Date Issued R e m a r k s

Approved by: Delivered by:

Number of ACIC(s) : __________________________________

Grand Total : _________________________________________

Amount in Words : _________________________________________________________________________________

Certified Correct by : Received by:

Approved by: Delivered by:

CANCELLED CHECK


Disbursing Officer/Cashier/Head of

Cash/Treasury Unit

Signature over Printed Name of GSB

personnel who received the ACIC


Head of Office/Unit or his/her

authorized representative

Signature over Printed Name of Agency personnel

who delivered the ACIC to the GSB

Signature over Printed Name of Head

of Office/Unit or his/her authorized

representative


Agency personnel who delivered the

ACIC to the GSB

R E P O R T S U M M A R Y


Disbursing Officer/Cashier/Head of

Cash/Treasury Unit

Signature over Printed Name of GSB personnel who

received the ACIC


NAMEGROSS

AMOUNT

WITHHOLDING

TAX

NET

AMOUNT

FOR MDS-

GSB USE

ONLY

P______ P _____ P ______ -

Certified Correct: Approved:

To: MDS-GSB of the Agency

Please debit MDS Sub-Account Number : ________________________________

Please credit the accounts of the above listed creditors to cover payment of accounts payable

TOTAL AMOUNT : P

Department : Department of Finance LDDAP-ADA No. ________________

Entity Name : National Tax Research Center Date : __________________________

Sub-total

I. Current Year A/Ps

Operating Unit : _________________________ Fund Cluster : 01

MDS-GSB BRANCH/MDS SUB ACCOUNT NO.: _____________________________

I. LIST OF DUE AND DEMANDABLE ACCOUNTS PAYABLE (LDDAP)

CREDITOR

Obligation

Request and

Status No.

ALLOTMENT

CLASS per

(UACS)

In Pesos

REMARKSPREFERRED SERVICING

BANKS/SAVINGS/CURRENT

ACCOUNT NO.

II. Prior Year's A/Ps

Sub-total

TOTAL

I hereby warrant that the above List of Due and

Demandable A/Ps was prepared in accordance with existing

budgeting, accounting and auditing rules and regulations.

Agency Authorized Signatories

1. 2.

(Erasures shall invalidate this document)

I hereby assume full responsibility for the veracity

and accuracy of the listed claims, and the authencity of

the supporting documents as submitted by the

claimants.

(Signature over Printed Name)

Head of Accounting Division/Unit

(Signature over Printed Name)

Head of Agency or

II. ADVICE TO DEBIT ACCOUNT (ADA)

(In Words)

FORMS AFB – Budget and Cash Division - List of Due and Demandable

Accounts Payable – Advice to Debit Accounts (LDDAP-ADA)

Prepared by:


Approved by:


Executive Director




Cash Disbursements Register

Prepared by:


Approved by:



Entity Name: National Tax Research Center Name of Accountable Officer: Milagros Alvarez

Official Designation: ____________________________

Station: _______________________________________

Register No. : __________________________________

Sheet No. : ____________________________________

(50101010) (50101020) (50203010)

Totals

Recapitulation:

Account Description

UACS

Object

Code

Amount

Total


Date: ____________________


Date: ______________________

Amount

The total of the ‘Advances for Operating Expenses – Payments’ column must always be equal to the

sum of the totals of the ‘Breakdown of Payments’ columns.

CERTIFIED CORRECT: RECEIVED BY:

________________________

DateDV/Payroll/

Check No.Particulars

Advances for BREAKDOWN OF PAYMENTS

(19901010)

Amount Salaries

and Wages

Salaries and

Wages -

Office

Supplies

O T H E R S

Cash

Advance

Payments Balance

Account

Description

UACS

Object

CASH DISBURSEMENTS REGISTER

Sub-Office/District/Division: __________________________

Municipality/City/Province: ___________________________

Fund Cluster : 01

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