DV Template
DV Template
DV Template
Fund Cluster :
Entity Name
Date :
DISBURSEMENT VOUCHER DV No. :
Mode of
Payment MDS Check Commercial Check ADA Others (Please specify)
_________________
TIN/Employee No.: ORS/BURS No.:
Payee
Address
Amount Due
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
________________________________________
Deputy Administrator for RDB
B. Accounting Entry:
Account Title UACS Code Debit Credit
Supp
proper
Signature Signature
Printed
Printed Name
Name
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
Date :
DV No. :
____________
ORS/BURS No.:
Amount
Credit
horized Representative