Professional Documents
Culture Documents
Obligation Request & Status (ORS)
Obligation Request & Status (ORS)
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
Printed
Name: ATTY. MARIO JAY PIELAGO Printed Name: EDEN B. ALOJACIN
Date ________________________
Date : ____________________________
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