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  • Obligation Request & Status (ORS)

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    Jay-r Rbar
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    This document is an Obligation Request and Status form requesting 3,500 pesos for travel allowance and per diem incurred during official travel in March 2016. It contains the payee's information, the purpose of the travel, and signatures from the requesting office representative and budget officer certifying the availability of funds and obligation. The second document is a Report of Checks Issued listing a check for 44,000 pesos paid to ABC Corporation for an expenditure under the responsibility center code with the corresponding UACS and disbursement voucher numbers. The disbursing officer certifies this is a full and accurate report of checks issued for the period.

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    This document is an Obligation Request and Status form requesting 3,500 pesos for travel allowance and per diem incurred during official travel in March 2016. It contains the payee's information, the purpose of the travel, and signatures from the requesting office representative and budget officer certifying the availability of funds and obligation. The second document is a Report of Checks Issued listing a check for 44,000 pesos paid to ABC Corporation for an expenditure under the responsibility center code with the corresponding UACS and disbursement voucher numbers. The disbursing officer certifies this is a full and accurate report of checks issued for the period.

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    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    602 views2 pages

    Obligation Request & Status (ORS)

    Uploaded by

    Jay-r Rbar
    This document is an Obligation Request and Status form requesting 3,500 pesos for travel allowance and per diem incurred during official travel in March 2016. It contains the payee's information, the purpose of the travel, and signatures from the requesting office representative and budget officer certifying the availability of funds and obligation. The second document is a Report of Checks Issued listing a check for 44,000 pesos paid to ABC Corporation for an expenditure under the responsibility center code with the corresponding UACS and disbursement voucher numbers. The disbursing officer certifies this is a full and accurate report of checks issued for the period.

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    © All Rights Reserved
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    of 2

    Annex F

    OBLIGATION REQUEST AND STATUS (ORS) No. : __________________

    DAR-Misamis Oriental
    Date: __________________
    Agency Fund: 101
    Payee CASSER B. AMEROL
    Office Department of Agrarian Reform-Misamis Oriental
    Address Max suniel St., Carmen, Cagayan de Oro City
    UACS Code/ Expenditure
    Responsibility
    Particulars MFO/PAP Amount
    Center
    502-01-010-00

    PLA-QUASI-JUDICIAL
    To obligate payment of Travelling activity to be charged
    allowance and per diem incured while of
    official travel for the Month of March 2016 3,500.00
    in the amount of…

    Total
    A. CertiCharges to appropriation/alloment B. Certified: Allotment available and obligated
    necessary, lawful and under my direct supervision; and for the purpose/adjustment necessary as
    supporting documents valid, proper and legal indicated above

    Signature : ____________________________________ Signature : ___________________________

    Printed
    Name: ATTY. MARIO JAY PIELAGO Printed Name: EDEN B. ALOJACIN

    Position : Trial Attorney V- Chief Legal Division Position : OIC-Budget Officer


    Head, Requesting
    Office/Authorized Representative Head, Budget Unit/Authorized Representative

    Date ________________________
    Date : ____________________________

    note: Please indicate the activity to be charged

    for LTS, ALS, TAS

    C. STATUS OF OBLIGATION
    Reference Amount
    Balance
    ORS/JEV/RCI/ RADAI Obligation Payable Payment
    Date Particulars Not Yet Due Due and
    No. Demandable
    (a) (b) (c) (a-b) (b-c)

    45
    Proposed
    REPORT OF CHECKS ISSUED
    Period Covered: ________________
    01/28
    2014-01-028
    Agency : JDG Department Report No.: ___________
    Fund : 01
    1234
    Bank Name/Account No. _________________ 1
    Sheet No.: _______________
    Check DV No. / ORS/BUR Responsibility UACS Code/
    Payee MFO/PAP/KRA Amount
    Date No. Payroll No. Center Code Expenditure
    1/28 023 2014-02-010 010 26-036-00-00000 ABC Corporation 3 01 01 0000 50604050 03 44,000 00
    123

    44,000 00

    CERTIFICATION
    I hereby certify that this Report of Checks Issued (RCI) in _________ sheet(s) is a full,
    true and correct statement of all checks issued by me in payment for obligations for the period stated and
    shown in the attached disbursement vouchers.
    AO 6/15/02

    Juan dela Cruz 01/29/14


    Disbursing Date
    Officer

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