Professional Documents
Culture Documents
Cash Disbursements Record: Entity Name: Fund Cluster: Sheet No.
Cash Disbursements Record: Entity Name: Fund Cluster: Sheet No.
Nature Cash
ADA/Check/ UACS Cash
of Advance Disburse
Date DV/Payroll/Refer Payee Object Advance
Paymen Received/ ments
ence No. Code Balance
t (Refunded)
CERTIFICATION
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 PRINCIPAL of MULAO ES during the period from _______________ to
___________________________, inclusive, as indicated in the corresponding columns.
IRENEO C. TONACAO
Name and Signature of Disbursing Officer
Date: ___________________________