Enclosure No. 2 to DepEd Order No. , s.

2020

PAYROLL MASTERLIST FOR TEACHER MEDICAL EXAM

(Name of School-Schools Division Office-Regional Of

Entity Name: DEPARTMENT OF EDUCATION

Fund Cluster: ____________________
We acknowledge receipt of the cash shown opposite our name and certify that said amount have been incurred for medical examination
Financial Assistance to Public School Teachers for Payment of Medical examination Expenses

Serial
Name Designation
No.
1
2 AQUINO, ARLENE M. T-lll
3 MALIMUTIN,MARIA PAZ R. T-I
4 SAMONTE TERESITA G. T-I
5 JESSA R PAYGANE T-I
6 PADAON, JOENALEN M. T-I
7 FE G.HUINDA T-II
8 JOESALYN ASTILLERO T-1
9 MICHELLE N. CALALO T-II
10 CASIPIT, RAISA A. T-lll
11 MARIA JOY C. LABAY T-III
12 CRISELDA A. AGBAY T-III
13 CRIS ANN B BONDAD T-I
14 JOSELITO H. SUMANGIL T-I
15 GAZETTE I. NILO T-I
16 CRESANDRA A. REYES T-I
17 ILMA M. FUCIO MT-II
18 CARLITA A. MELENDRES MT-1
19 MARILOU A. AUDINE T-1
20 ELLEN A. LATIZA T-II
21 NELSON T. DEANGKINAY JR. T-1
22
23
TOTAL
A
CERTIFIED:Services duly rendered as stated

Signature over printed Name of Authorized Official

B
CERTIFIED: Supporting documents complete and proper, and cash available in the amount of
 P 10,500.00

Head of Accounting Division/Unit

FOR TEACHER MEDICAL EXAMINATION ASSISTANCE
Schools Division Office-Regional Office) FY 2020

Payroll No.: _____________

Sheet ____ of ____ Sheets
ve been incurred for medical examination as contemplated in depEd Order No. ____ entitled "Guidleines on the Grant of Five Hundered Pesos (Php

TIN NO. ACCOUNT NO. Gross Amount Earned Net Amount Due

500.00 500.00
112-407-481 CA1895017457 500.00 500.00
719-455-208 CA1895033436 500.00 500.00
218-062-178 CA1895019255 500.00 500.00
729-587-339 CA1895032588 500.00 500.00
412-509-435 CA1895032510 500.00 500.00
219-784-041 CA 1895018445 500.00 500.00
208-057-720 CA1895029498 500.00 500.00
259-297-881 CA 2225030122 500.00 500.00
125-845-591 CA1895017830 500.00 500.00
221-924-053 CA1895026219 500.00 500.00
159-977-078 CA1895017325 500.00 500.00
467-888-786 CA1895030852 500.00 500.00
178-096-766 CA1895032855 500.00 500.00
734-025-239 CA1895032820 500.00 500.00
468-426-505 CA1895031727 500.00 500.00
915-154-805 CA1895018194 500.00 500.00
226-206-042 CA1895018747 500.00 500.00
416-369-621 CA1895026251 500.00 500.00
217-972-901 CA1895018569 500.00 500.00
463-489-193 CA1895032235 500.00 500.00
500.00 500.00

TOTAL 10,500.00 10,500.00

C APPROVED FOR PAYMENT:
Five Hundred Pesos Only

Head of Agency/ Authorized Representative

D
in the amount of CERTIFIED: Each employee whose name appears above has been paid the amount indicated
opposite on his/her name

Disbursing Officer/Cashier Unit Head

 Appendix 33

ayroll No.: ________________

heet ____ of ____ Sheets
of Five Hundered Pesos (Php 500)

Signature of Recipient

###

nly

Date:

amount indicated
ALOBS No._______________
Date ____________________
JEV No __________________
Date ____________________
Enclosure No. 2 to DepEd Order No. , s. 2020

PAYROLL MASTERLIST FOR TEACHER MEDICAL EXAM

(Name of School-Schools Division Office-Regional Of

Entity Name: DEPARTMENT OF EDUCATION

Fund Cluster: ____________________
We acknowledge receipt of the cash shown opposite our name and certify that said amount have been incurred for medical examination
Financial Assistance to Public School Teachers for Payment of Medical examination Expenses

Serial
Name Designation
No.
1 ERVIN C. REYES P-I
2 AQUINO, ARLENE M. T-lll
3 MALIMUTIN,MARIA PAZ R. T-I
4 SAMONTE TERESITA G. T-I
5 JESSA R PAYGANE T-I
6 PADAON, JOENALEN M. T-I
7 FE G.HUINDA T-II
8 JOESALYN ASTILLERO T-1
9 MICHELLE N. CALALO T-II
10 CASIPIT, RAISA A. T-lll
11 MARIA JOY C. LABAY T-III
12 CRISELDA A. AGBAY T-III
13 CRIS ANN B BONDAD T-I
14 JOSELITO H. SUMANGIL T-I
15 GAZETTE I. NILO T-I
16 CRESANDRA A. REYES T-I
17 ILMA M. FUCIO MT-II
18 CARLITA A. MELENDRES MT-1
19 MARILOU A. AUDINE T-1
20 ELLEN A. LATIZA T-II
21 NELSON T. DEANGKINAY JR. T-1
22
23
TOTAL
A
CERTIFIED:Services duly rendered as stated

Signature over printed Name of Authorized Official

B
CERTIFIED: Supporting documents complete and proper, and cash available in the amount of
 P 10,500.00

Head of Accounting Division/Unit

FOR TEACHER MEDICAL EXAMINATION ASSISTANCE
Schools Division Office-Regional Office) FY 2020

Payroll No.: _____________

Sheet ____ of ____ Sheets
ve been incurred for medical examination as contemplated in depEd Order No. ____ entitled "Guidleines on the Grant of Five Hundered Pesos (Php

TIN NO. ACCOUNT NO. Gross Amount Earned Net Amount Due

172-784-099 CA2225-0410-27 500.00 500.00

112-407-481 CA1895017457 500.00 500.00
719-455-208 CA1895033436 500.00 500.00
218-062-178 CA1895019255 500.00 500.00
729-587-339 CA1895032588 500.00 500.00
412-509-435 CA1895032510 500.00 500.00
219-784-041 CA 1895018445 500.00 500.00
208-057-720 CA1895029498 500.00 500.00
259-297-881 CA 2225030122 500.00 500.00
125-845-591 CA1895017830 500.00 500.00
221-924-053 CA1895026219 500.00 500.00
159-977-078 CA1895017325 500.00 500.00
467-888-786 CA1895030852 500.00 500.00
178-096-766 CA1895032855 500.00 500.00
734-025-239 CA1895032820 500.00 500.00
468-426-505 CA1895031727 500.00 500.00
915-154-805 CA1895018194 500.00 500.00
226-206-042 CA1895018747 500.00 500.00
416-369-621 CA1895026251 500.00 500.00
217-972-901 CA1895018569 500.00 500.00
463-489-193 CA1895032235 500.00 500.00
500.00 500.00

TOTAL 10,500.00 10,500.00

C APPROVED FOR PAYMENT:
Five Hundred Pesos Only

Head of Agency/ Authorized Representative

D
in the amount of CERTIFIED: Each employee whose name appears above has been paid the amount indicated
opposite on his/her name

Disbursing Officer/Cashier Unit Head

 Appendix 33

ayroll No.: ________________

heet ____ of ____ Sheets
of Five Hundered Pesos (Php 500)

Signature of Recipient

###

nly

Date:

amount indicated
ALOBS No._______________
Date ____________________
JEV No __________________
Date ____________________