Appendix _____

CASH JOURNAL
Month ______________________
Agency _________________
Fund _________________ Sheet No. ______________

C O L L E C T I O N S R E M I T T A N C E

Credit Debit

Date RCD No. JEV No. Name of Collecting Debit SUNDRY SUNDRY Credit

Officer 106 Acct. Code P Amount Acct. Code P Amount 106

 Appendix

CHECK DISBURSEMENTS JOURNAL

Month
Agency
Fund Sheet No.

Serial No. of CREDIT DEBIT

Name of
Checks Disbursing S UND R Y SUNDRY
DATE JEV RCI/DV Officer
No. No. From To Acct. Code P Amount Acct. Code P Amount
21

AO 5-14-02
 Appendix ______

CASH DISBURSEMENTS JOURNAL

Month ___________________________
Agency
Fund Sheet No.

CREDIT DEBIT

SUNDRY SUNDRY
DATE JEV No. RD No. Name of Disbursing Officer

Acct. Code P Amount P

Acct. Code Amount
23

AO 5-14-02
 Appendix ______

CHECK DISBURSEMENTS RECORD

Agency
Fund Sheet No.

Accountable Officer Official Designation Station

Check NCA
Date Date Name of Payee UACS Code Nature of Payment Received/ Checks Bank/NCA
No. Released Deposit Made Issued Balance

Received

CERTIFICATION

I hereby certify that the foregoing is a correct and complete record of all checks
issued by me in my capacity as ____________________ of ___________________________
______________ during the period from _______________ to _______________, inclusives,
as indicated in the corresponding columns.

___________________________
Name and Signature
________________
Date
For Accountable Officers' Use
 Appendix 35

REPORT OF CHECKS ISSUED

Period Covered: January to June 2023

Entity Name : DATU UDTOG MATALAM SR. MEMORIAL HIGH SCHOOL

Fund Cluster : MAGUINDANAO DEL SUR Report No.: ___1_______
Bank Name/Account No. : Land Bank of the Philippines Sheet No.: _____1______

Check Responsibility UACS Object

DV/Payroll No. ORS/BURS No. Payee Nature of Payment Amount
Date Serial No. Center Code Code

4/18/2023 2935520 DV-01-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱45,000.00

4/18/2023 2935521 DV-02-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱50,000.00
4/18/2023 2935522 DV-03-2023 Jo Alexander M. Belotindos Cash Advance MOOE ₱45,000.00
4/18/2023 2935523 DV-04-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱45,000.00
4/18/2023 2935524 DV-05-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱45,000.00
₱50,000.00
98

4/18/2023 2935525 DV-06-2023 Abdulrahman M. Kamansa Cash Advance MOOE

5/18/2023 2935526 DV-07-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱50,000.00
5/18/2023 2935527 DV-08-2023 Jo Alexander M. Belotindos Cash Advance MOOE ₱45,000.00
5/18/2023 2935528 DV-09-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱45,000.00
5/18/2023 2935529 DV-10-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱45,000.00
5/18/2023 2935530 DV-11-2023 Jo Alexander M. Belotindos Cash Advance MOOE ₱50,000.00
5/18/2023 2935531 DV-12-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱45,000.00
5/18/2023 2935532 DV-13-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱45,000.00
6/22/2023 2935533 DV-14-2023 Jo Alexander M. Belotindos Cash Advance MOOE ₱45,000.00
6/22/2023 2935534 DV-15-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱45,000.00
6/22/2023 2935535 DV-16-2023 Abdulrahman M. Kamansa Cash Advance MOOE ₱45,000.00
CERTIFICATION
I hereby certify on my official oath that this Report of Checks Issued in _________ sheet(s) is a full, true and correct
statement of all checks issued by me during the period stated above for which Check Nos. ___________ to _____________ inclusive,
were actually issued by me in payment for obligations shown in the attached disbursement vouchers/payroll.

JO ALEXANDER M. BELOTINDOS
Name and Signature of Disbursing Officer/Cashier
Teacher - I ______________
Official Designation Date