REPORT OF ACCOUNTABILITY FOR ACCOUNTABLE FORMS

For the Month of _________, 20____

Barangay: _______________________________ City/Municipality: ________________ RAAF No. _______

Barangay Treasurer: _______________________ Province: ______________________

Beginning Balance Receipt Issued Ending Balance

Name of Form Inclusive Serial Nos. Inclusive Serial Nos. Inclusive Serial Nos. Inclusive Serial Nos.
QTY QTY QTY QTY
From To From To From To From To
A. With Money Value
Cash Tickets

B. Without Money Value

Official Receipts
Checks

CERTIFICATION:
I hereby certify that the foregoing is a true statement of all accountable forms received, issued and
transferred by me during the above-stated period and the correctness of the beginning balances.

__________________________________ __________________
(Name and Signature) Date
Barangay Treasurer
 REPORT OF COLLECTIONS AND DEPOSITS

Name of Barangay Treasurer: ________________________ Date: _________________

Barangay: ________________________________________ RCD No.: ______________
A. COLLECTIONS

Official Receipt/RCR
Payor Nature of Collection Amounts
Date Number

TOTAL

B. DEPOSITS

Bank/Branch Reference Amount

TOTAL

C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS

Beginning Balance Receipt Issued Ending Balance

Name of Form and No. Inclusive Serial No. Inclusive Serial No. Inclusive Serial No.
Qty Qty Qty Qty
From To From To From To From To

With Money Value:

Without Money Value:

D. CERTIFICATION:

I hereby certify that this Report of Collections and Deposits; and Accountable Forms including supporting documents are true and correct

_______________ _______
Barangay Treasurer Date

E. ACCOUNTING ENTRIES

Account Title Account Code Debit Credit

Prepared by: ______________________ Approved by: _____________________

Barangay Bookkeeper City/Municipal Accountant

 Disbursement Voucher DV No. :
Barangay: City/Municipality:  Date :
Payee:  Province:   Fund:
Address:  TIN :  
Particulars Amount

B. Certified As to availability of funds for  C. Certified as to validity,

A. Certified as to existence of
the purpose, and completeness and propriety propriety, and legality of claim and
appropriation for obligation
of supporting documents approved for payment:

_______________________ _________________________ _________________________

(Signature Over Printed Name) (Signature Over Printed Name) (Signature Over Printed Name)
Chairman, Committee on
Barangay Treasurer Punong Barangay
Appropriation
Date : ____________ Date : _____________ Date : ______________
D. Received Payment:
Check
Bank
OR
No.:
Name:_
___________________________ No.: Date: ____________
______
Signature Over Printed Name ______
___
______
_
E. Accounting Entries
Account Account Code  Debit Credit

Prepared By:

______________________ ___________
Barangay Bookkeeper Date

Approved By:
______________________ ___________
City/Municipal Accountant Date
 Name of Barangay
Address

INVENTORY CUSTODIAN SLIP

Barangay:___________ City/Municipality:________ ICS No.:__
Quantity Unit Description Estimated Useful Life

Received by: Issued by:

 ___________________________
__________________________
(Signature over Printed Name) (Signature over Printed Name)
Recipient Barangay Treasurer

____________ __________
Date Date

Tel. No.:_____________ Province:_______________________

 PROPERTY ACKNOWLEDGEMENT RECEIPT
Barangay: City/Municipality: PAR No.:

Tel. No.: Province:

Quantity Unit Description Property No. Date Acquired Cost

Received by: Issued by:

________________________ ________________________

Signature over Printed Name Signature over Printed Name

Recipient/User Barangay Treasurer

___________ ___________

Date Date
 PROPERTY/EQUIPMENT CARD

__________________________________

Barangay, City/Municipality, Province

Property No.
Property/Equipment:

Location:

Description: Classification:

Date of Purchase Particulars Cost Improvement/Repairs Transfers/etc. Total

 Report on Inventory of Property and Equipment

As of ________________________

Barangay: _________________________ City/Municipality: _______________________________

Tel. No.: __________________________ Province: _____________________________________

For which _________________________________ is accountable

(Name of Accountable Officer)(Official Designation)

Balance PEC On Hand per count Shortage/Overage

Article Description Property /ICS Number Unit of Measure Unit Value Remarks
(Quantity) (Quantity)
Quantity Value
Part A – Property and equipment covered by PAR

Part B – Property and equipment covered by ICS

Prepared by: Approved by:

________________________ ________________________ _____________________________

Signature over Printed Name Signature over Printed Name Signature over Printed Name

Barangay Treasurer Punong Barangay or Representative Punong Barangay

Member, Inventory Committee Chairman, Inventory Committee

____________________

Date

________________
Date
 REPORT ON INVENTORY OF SUPPLIES AND MATERIALS
As of ___________________

Barangay : _______________________________________ City/Municipal : _________________________________________

Tel. No. : _______________________________________ Province : _____________________________________________

For which is accountable, having assumed accountability on ____________________.

(Name of Accountable Officer) (Official/Designation) (Date of Assumption)

STOCK UNIT OF UNIT BALANCE PER ON HAND PER SHORTAGE / OVERAGE

ARTICLE DESCRIPTION REMARKS
NUMBER MEASURE VALUE CARD (Quantity) COUNT (Quantity)
Quantity Value

Prepared by: Approved by:

_______________________ _______________________ _______________________

Signature over Printed Name Signature over Printed Name Signature over Printed Name
Barangay Treasurer Punong Barangay or Representative Punong Barangay
Member, Inventory Committee Chairman, Inventory Committee

_______________________ _______________________ _______________________

Date Date Date
 SUMMARY OF SUPPLIES AND MATERIALS ISSUED

_________________________________________
Barangay, City/Municipality, Province

For the Period _____________ to _____________, 20___

No.: ___________________

ITEM Requisition and Issue Slip Numbers Quantity Issued Total

Unit of
Quantity Unit Cost Total Cost
Measurement
No. Description (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Issued

Prepared by: Certified by: Posted in the SLC by/date:

____________________ ____________________ ____________________

Clerk Supply Officer Accounting Clerk
 ACKNOWLEDGEMENT RECEIPT FOR DONATED

PROPERTY, EQUIPMENT, SUPPLIES AND MATERIALS

Barangay : ____________________________________ Date : ________________________________

Province/City/Municipality : _______________________ ARDPESM No.:_________________________

Authorized Representative : _________________________________________________________________________

Address: ________________________________________________________________________________________
Quantity Unit Description Value

Total

Purpose of Donation:

_________________________________________________________________________________
Received the donated articles for the purpose stated above.

_____________________________________

Printed Name and Signature of the Punong Barangay/

Authorized Representative

Conforme:

__________________________________

Printed Name and Signature of the Donor/

Authorized Representative
 Annex 6

RECORD OF APPROPRIATIONS AND OBLIGATIONS

Barangay: City/Municipality: Page No.:
Chairman: Province:

Capital Outlay Personnel Services Maintenance and Other Operating Expences Financial Expenses Capital Outlay
Date
Reference No. Total
A. Appropriations
-
-
-
-
-
-
-

Total - - - - - - - - - - - - - - -
B. Obligations

Total - - - - - - - - - - - - - - -
 REGISTRY OF SPECIAL TRUST FUND
Barangay: ___________________ City/Municpality: _______________ Page No.: _____________
Chairman: __________________
Province: ____________________
Purpose: _____________________

Date Particulars Ref. Amount Year

 Annex 41

RECORDS OF ESTIMATED AND ACTUAL INCOME

Barangay: City/Municipality: Page No.:

Barangay Treasurer: Province:

Income Accounts
Date Particulars Refence

A. Income Estimates

B. Actual Collections
 Annex 8
CASHBOOK
Barangay:
Barangay Treasurer:
Calendar Year:

Cash in Local Treasury Cash in Bank Cash Advance Petty Cash

Date Particulars Reference Check Replenishment
Collection Deposit Balance Deposit Balance Received Disbursement Balance Received Balance
Issued (Payments)

CERTIFICATION:

I hereby certify that the forgoing is a correct and complete record of all my collections,
deposits/remittances and balances of my accounts in the Cash-in Local Treasury, Cash in Bank,
Cash Advances, and Petty Cash as of ____________.

___________________
Name and Signature
__________
Date
 Annex 7
Barangay
City/Municipality, Province
Statement of Appropriations, Obligations and Balances
For the Year 20___
(In Philippine Peso)

Code Function/Program/Project Appropriations Obligations Balances

I. Current Year Appropriations
Personnel Service
Maintenance and Other Operating Expenses
Capital Outlay
Financial Expenses
20% Development Fund
10% Sangguniang Kabataan Fund
5% Local Disaster Risk Reduction and Management Fund

II. Continuing Appropriations

Capital Outlay
20% Development Fund

Certified Correct: Noted By:

____________________________________ ______________________
Chairman, Committee on Appropriations Punong Barangay

_____________ _____________
Date Date
 No.:_____________
PETTY CASH VOUCHER
Date: ____________
Barangay: _____________________ City/Municipality: ________________________
Payee : _______________________ Province : ______________________________
I. To be filled up upon request
Particulars Amount II. To be filled up upon liquidation
Total Amount Granted -
Total Amount Paid -
Amount Refunded/ (Reimbursed) -
A. Requested by: C.
Received Refund
____________________
Name of Requestor Reimbursement Paid

Approved by:

____________________ _______________
Punong Barangay Barangay Treasurer
B. Paid by: D.
Liquidation Submitted by:
_____________________
Barangy Treasurer Reimbursement Received by:

Cash Received by:

___________________________ ______________________________
Signature over Printed Name of Payee Signature over Printed Name of Payee

Date: __________________________ Date: __________________________

 PETTY CASH RECORD

_________________________
Barangay, City/Municipality

Petty Cash Custodian : _____________________ Fund : ____________________

Date Particulars Reference Debit Credit Balance

 Payroll 
Period Covered: __________________________________ 

Barangay: __________________ City/Municipality: ______________________________  Payroll No. ______________________

Barangay Treasurer: __________ Province: ____________________________________

Compensation Deduction
No. Name Position Salaries & BIR Wholding Net Amount Due Signature of Recipient
Honoraria Other Benefits Total Total
Wages Tax

A. Certified:  B. Certified:  C. Certified:  D. Certified: 

As to availability of appropriation  All supporting documents valid and complete.  As to validity, propriety and legality of claim. 
Each official/employee whose name appears on the above
For obligation in the amount of ________.  Approved for Payment:  roll has been paid the amount stated opposite his name 

Signature: ________________________ Signature: ____________________________ Signature: ____________________________  Signature: ____________________________ 

Printed Name: ____________________ Printed Name: _________________________ Printed Name: _________________________  Printed Name: _________________________ 

Position: Chairman, Com. On Appropriations  Position: Barangay Treasurer  Position: Punong Barangay  Position: Punong Barangay 

Date: ____________________ Date: ____________________ Date: ____________________ Date: ____________________

E. Accounting Entries

Account Title  Account Code Debit Credit Prepared By: 

___________________ _______
Barangay Bookkeeper Date

Approved by:
___________________ _______
City/Municipal Accountant Date
 LIQUIDATION REPORT 
No.:_______________
_______________________________ 
Barangay, City/Municipality, Province  Date.:_____________

PARTICULARS AMOUNT

TOTAL AMOUNT SPENT ---->

AMOUNT OF CASH ADVANCE PER DV NO._____DTD.___ ---->
TOTAL AMOUNT SPENTAMOUNT REFUNDED PER O.R.
NO._____DTD_______ ---->
AMOUNT TO BE REIMBURSED ---->
Submitted by:  Received by: 

________________________  ________________________ 
Accountable Officer Accounting Unit

___________________ ___________________
Date Date

ACCOUNTING ENTRIES
Account Titles Account Code Debit Credit
 Barangay _______________
Municipality of ________________
Province of __________________

TRANSMITTAL LETTER

Date ______________

To: The Municipal Accountant

Municipality of _____________

Sir/ Madam:

We submit herewith the following documents: a) certified copy of the cashbook; b) copy of PBCs
issued; and c) original of the Disbursement Voucher/payroll issued for the ____________________duly
acknowledged by the payees.

A. DV/Payroll
DV/Payroll Check PB Certification
Date No. Date No. Payee Amount Date No.

B. RCDs/RCRs
Date No. Amount

C. Other Reports
Date Type of Reports

Please acknowledge receipt hereof.

Very truly yours,

Barangay Treasurer

Noted by: Received by:

Punong Barangay Signature, Name and Designation

 REQUISITION AND ISSUE SLIP

Barangay: City/Municipality: RIS No.:

Tel. No.: Province: Date:
Requisition Issuance
Unit Particulars Quantity Qty Remarks

Purpose:

Requested by: Approved by: Issued by: Received by:

Signature
Printed Name
Designation
Date
 STOCK CARD
Supplies:_____________ Supplies Number:_____________
Description:_____________

Quantity Issuance
Date Reference Balance
Received Quantity Received by
 PURCHASE REQUEST

Barangay: _____________ P.R. No.: _____________

City/Municipality: ________ Date.:________________
Province: ______________
REQUISITION
Item Unit of Estimated Estimated
Qty Item description
Number Measurement Unit Cost Amount

Total Estimated Amount

Purpose:

Requested by: Approved: 

_________________________  _________________________ 
Signature over Printed Name Signature over Printed Name
Requesting Officer Punong Barangay 

_________________  _____________ 
Date Date
 PURCHASE ORDER

Barangay: _______________________ City/Municipality: ______________________

Tel. No.: _________________________ Province: _____________________________
Supplier: _________________________ PO No.: _____________________________
Address: _________________________ Date: _______________________________
TIN: _____________________________ Mode of Procurement:
[ ]  [ ]  [ ] 
Over the
Bidding Negotiated
Counter
Gentlemen:

Please deliver to this office the following articles subject to the terms and conditions
contained herein
Place of Delivery: Delivery Term:
Date of Delivery: Payment Term:
Unit Particulars Quantity Unit Cost Amount

(Total Amount in words)

In case of failure to make full delivery within the time specified above, a penalty of one-
tenth (1/10) of one percent for everyday of delay shall be imposed.

Very truly yours,

__________________ 
Punong Barangay

Conforme: Existence of Available Appropriations of 

________________________  ________________________ 
(Signature over Printed Name)  (Signature over Printed Name) 
Supplier  Chairman, Committee on Appropriations 

_______________  _______________ 
Date Date
 CASHBOOK
Barangay:
Barangay Treasurer:
Calendar Year:

Cash in Local Treasury Cash in Bank

Date Particulars Reference Check
Collection Deposit Balance Deposit Balance
Issued

CERTIFICATION:

I hereby certify that the forgoing is a correct and complete record of

deposits/remittances and balances of my accounts in the Cash-in Loc
Cash Advances, and Petty Cash as of ____________.
 Annex 8
ASHBOOK

Cash Advance Petty Cash

Received Disbursement Balance Received Replenishment Balance

(Payments)

a correct and complete record of all my collections,

s of my accounts in the Cash-in Local Treasury, Cash in Bank,
of ____________.

___________________
Name and Signature
__________
Date
 Inventory, Inspection and Appraisal Report
Barangay: City/Municipality: IIAR No.:
Tel. No.: Province: Page:
INVENTORY INSPECTION SALE
Net
Date Property Unit Total Accumulated Appraised Mode of Amount
Particulars Qty. Book Remarks OR. No.
Aquired No. Cost Cost Depreciation Value Desposition
Value

Certified Correct as to Cost and Depreciation: I certify to have inspected each I certify to have witnessed the
and every article enumerated in inspection of the articles
Prepared By:
this report. enumerated in this report.

_________________ ______________________ _______________ ____________

Signature over Printed Name Signature over Printed Name Signature over Printed Name Signature over Printed Name
Barangay Treasurer
City/Municipal Accountant Authorized Inspector Authorized Witness

Date: __________ Date: __________ Date: __________ Date: __________

Approved by:

____________________
Signature over Printed Name
Punong Barangay 

__________
Date
 ACCEPTANCE AND INSPECTION REPORT

Barangay: City/Municipality:
Tel. No.: Province:
Supplier: Invoice: AIR No.: RIS No.:
PO No.: No.: Date: Date:
Date: Date:
Unit Description Quantity

ACCEPTANCE INSPECTION

Date Inspected: Date Inspected:

Complete Inspected, verified as to quantity and specifications

Partial (Pls. specify quantity received

____________________________  __________________________ 
Signature over Printed Name Signature over Printed Name
Barangay Treasurer  Authorized Inspector
 Property/Equipment Ledger Card

____________________ _______________________
Barangay City/Municipality, Province
Property/Equipment: Account Code:
Est. Useful Life:
Description: Rate of Depreciation:

Receipt
Accumulated Transfer/
Date Reference Unit Total Balance
Qty. Depreciation Adjustment
Cost Cost
 Return and Receipt of Property/Equipment

Date: ______________
This is to acknowledge receipt of the Property/Equipment
Property/Equipment
Qty Property No. End user/Office Remarks
Description

Returned by: Received by:

______________________ ______________________
Signature over Printed Name Signature over Printed Name
 Journal of Cash Transaction
For the Month of ________

Barangay: _______________________ Sheet No: ________

City/Municipality: _________________
Province: _______________________

Cash - In Local Cash in Bank-

Reference Sundry Column
Treasury LCCA
Date Particular (RCD, Income Expenses
DV,JEV) Account Account
Debit Credit Debit Credit Debit Credit
Code Title

Certified Correct:

_________________________ __________________________ __________________________

Barangay Bookkeeper Chief Accountant Date
 GENERAL JOURNAL
_______________________________
Barangay, City/Municipality, Province

____________________
For the month of

Sheet No.________

JEV Amount
Date Particulars Account Title Account Code P
No.
Debit Credit

CERTIFIED CORRECT: 

______________________________ 
Signature over Printed Name 

______________________________
Designation 
 GENERAL LEDGER

Sheet No.____________

Account Title:________________ Barangay:____________________

Account Code:_______________ City/Municipality:_______________
Province:____________________

Amount
Date Particulars Reference
Debit Credit Balance
 SUBSIDIARY LEDGER
Sheet No. ____________

Account Title:_________________ Barangay:_______________________

Account Code:________________ 

Description: __________________  City/Municipality:__________________

Creditor/Debtor: _______________ 

Address: _____________________ Province:_______________________

Contact No.: __________________

Amount
Date Particulars Reference
Debit Credit Balance
 JOURNAL ENTRY VOUCHER
No. ___________
______________________________________
Barangay, City/Municipality, Province Date:__________

ACCOUNTING ENTRIES
Accounts and
Account Title Account Code Ref. Amount
Explanation
Debit Credit

Total

Prepared by:  Approved by: 

_____________________  ___________________________ 
Barangay Bookkeeper  City/Municipal Accountant 

Date:________ Date: __________

 BANK RECONCILIATION STATEMENT
For the Period ________________
(Date)

Barangay: __________________  City/Municipality:_________________

Tel. No. : ___________________ Province: ______________________
Bank Name: ________________ Current Account No.______________ 
Branch: ____________________
Particular Book Bank Explanatory Comment
Unadjusted Balances xxx xxx
Reconciling Items:
Check Issued not taken up:
By the Barangay (xx)
By the Bank (xx)
Check Issued Overstated:
By the Barangay xx
By the Bank xx
Check Issued Understated
By the Barangay (xx)
By the Bank (xx)
Deposits not taken up:
By the Barangay xx
By the Bank xx
Deposits Overstated:
By the Barangay (xx)
By the Bank (xx)
Deposit Understated:
By the Barangay xx
By the Bank xx
Bank Debit/Credit Memos, Not
take up by the Barangay:
Debit Memo (xx)
Credit Memo xx
Other Reconciling Items
Adjusted Balances xx xx
Prepared by: 

_______________________ 
City/Municipal Accountant