Appendix 47

Republic of the Philippines

Province of Cotabato
MUNICIPALITY OF ARAKAN

PURCHASE REQUEST

LGU: ARAKAN Fund: _______________________

Department : MASSO PR No.: ______________ Date: ____________
Section: Gen. Services FPP : ___________________

Item No. Unit Item Description Quantity Unit Cost Total Cost
1 set Donor Tax on purchase of Lot 82-F 1 12,141.45 12,141.45

-
-
TOTAL 12,141.45
Purpose Payment of donors tax of LGU Purchase Property on Lot 82-F.

Requested by: Cash Availability: Approved by:

Signature :
Printed Name : JONATHAN P. DURON JUPITER C. AMPATIN, CPA RENE V. RUBINO
Designation : Municipal Assessor Municipal Treasurer Municipal Mayor
 Appendix 47
Republic of the Philippines
Province of Cotabato
MUNICIPALITY OF ARAKAN

PURCHASE REQUEST
LGU: ARAKAN Fund: GF
Department :MASSO PR No.: _________________ Date: _____________
Section: Gen. Services FPP : ___________________

Item No. Unit Item Description Quantity Unit Cost Total Cost
1 pcs BIR certification 5.00 100.00 500.00
2 set DAR cert. 1.00 70.00 70.00
3 set PASSO cert. 1 990.00 990.00
4 pcs photocopy 92 2.00 184.00
5 set ROD cert. 1 341.54 341.54

-
-
CERTIFICATE OF EMERGENCY PURCHASE -
-
This is to certify that the above listed purchase were urgently needed and there was no ample time
to secure in the normal procedure as required by the existing rules and regulations without deterent -
to the service and that prices are just and reasonable at the time of purchase.

-
-
JONATHAN P. DURON
Municipal Assessor -
-
TOTAL 2,085.54
Purpose: Reimbursement of various expenses for the transfer of title..

Requested by: Cash Availability: Approved by:

Signature :

Printed Name : JONATHAN P. DURON JUPITER C. AMPATIN, CPA RENE V. RUBINO

Designation : Municipal Assessor Municipal Treasurer Municipal Mayor
 Appendix 2
Republic of the Philippines
Province of Cotabato
Municipality of Arakan
(Insert Name of Office)

FUND UTILIZATION REQUEST AND STATUS FURS No. : ______________

ARAKAN Date : __________________
LGU Fund :__________________

Payee

Office

Address

Project/Purpose Particulars Account Code Amount

Total

A. B.
Certified: Charges to special trust account necessary, Certified: Funds available and utilized for
lawful and under my direct supervision; and supporting the purpose/adjustment necessary as
documents valid, proper and legal indicated above

Signature : __________________________________ Signature : ____________________________

Printed Name: __________________________________ Printed Name: ____________________________

Position : __________________________________ Position : ____________________________

Head, Accounting Division/Unit/
Head, Requesting Office/Authorized
Authorized Representative
Representative
Date : _______________________________ Date : ____________________________
C. STATUS OF UTILIZATION
Reference Amount
Balance
FURS/JEV/RCI/ Utilization Payable Payment
Date Particulars Not Yet Due
RADAI No.
(a) (b) (c) (a-b)
 Appendix 29

_________
_________
________

Amount

ble and utilized for

necessary as

_____________

_____________

_____________
nting Division/Unit/
ed Representative
_____________
Balance
Due and
Demandable
(b-c)
 Appendix 31
DISBURSEMENT VOUCHER Fund: GENERAL FUND
MUNICIPALITY OF ARAKAN
DV No.:
Date:
ID No./TIN:
Payee: LIGA NG MGA BARANGAY ARAKAN CHAPTER
CAFOA No.:
Responsibility Center:
Address: Poblacion, Arakan Cotabato

Particulars Amount

To trasfer of fund from Municipal Fund to Liga ng mga Barangay Arakan Chapter
as Aid to Liga ng mga Barangay for Cy 2022 in the amount of …………. 100,000.00

TOTAL AMOUNT 100,000.00

A Certified: B Certified: C Certified:
Expenses/Cash Advances necessary, Completeness and propriety of supporting Funds available for the purpose.
valid, proper, lawful and incurred documents/previous cash advance
under my direct supervision. liquidated/existence of funds held in
trust.

RENE V. RUBINO JOHN N. MENDOZA, CPA JUPITER C. AMPATIN, CPA

Municipal Mayor Municipal Accountant Municipal Treasurer

D Approved For Payment: P E Received Payment:

D
D Payment:
Check No. _______________
Bank Name: _____________
RENE V. RUBINO Date: ___________________ LIGA NG MGA BARANGAY ARAKAN CHAPTER

Municipal Mayor Signature Over Printed Name/Position

Date: ___________

F Accounting Entries
Particulars Account Code Debit Credit

Prepared by: Certified Correct:

AIRA JUNE F. DANO JOHN N. MENDOZA, CPA

Admin. Assistant II Municipal Accountant
 Appendix 28
Republic of the Philippines
Province of Cotabato
MUNICIPALITY OF ARAKAN
OFFICE OF THE MUNICIPAL MAYOR

CERTIFICATION ON APPROPRIATIONS, FUNDS AND OBLIGATION OF ALLOTMENT

Obligation No.:
Request for trasfer of fund
Approved Amount:
Payee LIGA NG MGA BARANGAY ARAKAN CHAPTER
Certification:

I hereby certify as to the existence of appropriations

Function Allotment Expense Code Amount
Class for the expenditures in the amount specified herein:
1011 100,000.00

FELIX A. PATRIMONIO
Budget Officer Date

Certification:

Total amount requested: 100,000.00 I hereby certify as to the availability of funds for
the expenditures in the amount specified herein:
Amount in Words: One Hundred Thousand Pesos

JUPITER C. AMPATIN, CPA

Requesting Official: Municipal Treasurer Date

Certification:
RENE V. RUBINO I hereby certify that the allotments are available
Municipal Mayor Date for obligation in the amount specified herein:

JOHN N. MENDOZA, CPA

Municipal Accountant Date

Subsidiary Ledger
Date Particulars/Reference Liquidations Obligation Increase (Decrease) Balance
 WASTE MATERIAL REPORT
Arakan, Cotabato

Place of storage: GSO

ITEMS FOR DISPOSAL: RECORDS OF SALES
ITEM QTY UNIT DESCRIPTION O.R No. AMOUNT
1 0 0 -
2 0 0 -
3 0 0 -
4 0 0 -
5 0 0 -
6 0 0 -
7 0 0 -
8 0 0 -
9 0 0 -
10 0 0 -
11 0

-
Certified Correct: Disposal Approved:

HERMELITA M. SARONG JUPITER C. AMPATIN

Acting GSO Acting Municipal Treasurer

CERTIFICATE OF INSPECTION
I hereby certify that the property enumerated above was disposed as follows:

Item ____________ Destroyed

Item ____________ Sold at private sale
Item ____________ Sold at public auction
Item ____________ Transferred without cost to _____________

Property Inspector: Received by:

LARRY B. BEÑALON MARILYN L. CALEXTERIO

Inspection Officer-I Administrative Aide-I
 ACCEPTANCE & INSPECTION REPORT

LGU:__ Arakan Fund:__ GF

Supplier: __________________________________ AIR No.:______________
PO No./ Dept: ______________________________ Date:________________
Requisitioning Office/Department : MASSO Invoice No.:__________
Date:________________
Stock/ Property No. Description Unit Quantity

1 BIR Cert. pcs 5

2 DAR cert. set 1
3 PASSO Cert set 1
4 photocopy pcs 92
5 Xtra Advance ltrs. 9.34
6 ROD cert set 1

ACCEPTANCE INSPECTION

Date Received:___________________ Date Inspected: _______________

Complete Inspected, verified and found in order as

to quantity and specifications
Partial ( pls. specify)

HERMELITA M. SARONG JOHN N. MENDOZA, CPA

Supply and/or Property Custodian Inspection Officer/Inspection Committee
P
 No.:

LIQUIDATION REPORT Date:

Municipality of Arakan Responsibility Center:
Arakan Cotabato
Code:
PARTICULARS AMOUNT

TOTAL AMOUNT SPENT

AMOUNT OF CASH ADVANCE PER DV NO. DTD. -

AMOUNT REFUNDED PER O.R. NO. DTD.

AMOUNT TO BE REIMBURSED -

A Certified: Correctness of the B Certified: Purpose of Travel/Cash C Certified: Supporting documents

above data advance duly accomplished complete and proper

JOHN N. MENDOZA, CPA

Barangay Treasurer Barangay Captain Municipal Accountant JEV No.
 Republic of the Philippines
Province of Cotabato
Municipality of Arakan

POST REPAIR INSPECTION REPORT

As per inspection of ISUZU CROSSWIND (SKX 748 ) it is recommended that replacement of the
following:

ITEM QTY UNIT DESCRIPTION COST

1 1 0 EMISSION TEST 500.00
2 1 PACK GARBAGE BAG 590.00
3 #REF! #REF! #REF! 2,025.00
4 5 PCS RAINSUIT -
5 0 0 - -
6 0 0 - -
7 0 0 - -
8 0 0 - -
9 0 0 - -
10 0 0 - -
11 0 0 - -
12 0 0 - -
13 0 0 - -
14 0 0 - -
15 0 0 - -
16 0 0 - -

TOTAL ESTIMATED COST 3,115.00

Inspected By: Requested By:

RONALD M. TAPGOS
Mechanic Driver

Approved:

RENE V. RUBINO
Municipal Mayor
 Republic of the Philippines
Province of Cotabato
Municipality of Arakan

PRE-REPAIR INSPECTION REPORT

Equipment/Unit: CROSSWIND
Plate Number: SKX 748
Status: Condition

After inspection of the above mentioned unit it is found out that the following parts needs
replacement / repair with corresponding estimated cost.

ITEM QTY UNIT DESCRIPTION COST

1 1 set Donor Tax on purchase of Lot 82-F 12,141.45
2 0 0 - -
3 0 0 - -
4 0 0 - -
5 0 0 - -
6 0 0 - -
7 0 0 - -
8 0 0 - -
9 0 0 - -
10 0 0 - -
- -
11 0 0 - -
- -
- -
- -
- -
-

TOTAL ESTIMATED COST 12,141.45

Inspected By: Requested By:

JOHN A. ORBE
Mechanic Driver

Approved:

JUPITER C. AMPATIN, CPA

Municipal Treasurer
 Republic of the Philippines
Province of Cotabato
Municipality of Arakan
OFFICE OF THE MUNICIPAL TREASURER
Arakan, Cotabato

PR Number
PR Date
OFFICE CODE PARTICULARS F.P.P. Account Code Amount

1091 REPAIR AND MAINTENANCE OF TRANSPORTATION EQUIPMENT 17,060.00

TOTAL 17,060.00

Certified charges to appropriation:

JUPITER C. AMPATIN, CPA

Municipal Treasurer