Republic of the Philippines

Province of Cagayan
PROVINCIAL GOVERNMENT OF CAGAYAN
Capitol Hills, Tuguegarao City

No.
DISBURSEMENT VOUCHER
Mode of
Payment:
TIN/Employee No.: Obligation Request No.:
Payee: BGEN. RODOLDO G. ALVARADO(Ret.)
Responsibility Center
Address: Tuguegarao City Office/Unit/Project: Code:
PA

To reimburse payment of cellcard for the month of September, 2018

amounting to -------------------------------------------------------------------------------------------- 5,000.00

5,000.00
A. Certified: B. p
Allotment obligated for the purposes indicated above. Funds available

Supporting documents complete.

Signature:

Printed Name: JEANNA C. GARMA Date: Printed Name: MILA Q. MALLONGA Date:
Position: Provincial Accountant Position: OIC-Provincial Treasurer
Head, Accounting Unit/Authorized Representative Head,Treasury Unit/Authorized Representative
C. Approved for payment: D. Received payment:
Signature: Cheque No.: Bank Name:

Printed Name: BGEN. RODOLDO G. ALVARADO(Ret.) Date: Signature: Date:

Printed Name:
Position: Provincial Administrator O.R./Other documents: T.E.V. No. Date:
Agency Head/Authorized Representative