Sri Obligation Request

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Annex A

Republic of the Philippines


Province of Leyte
MUNICIPALITY OF MATALOM

OBLIGATION REQUEST No.


Payee
Office
Address

Responsibility Particulars F.P.P. Account Code Amount


Center

TOTAL -
A. Certified B. Certified

Charges to appropriation/allotment necessary, Existence of available appropriation


lawful and under my direct supervision.

Supporting documents valid, proper and legal

Signature Signature

Printed
Printed Name ENGR. ELBERT O. ACASIO Name ROMANITO P. PADA
Position Position
Head, Requesting Office/Authorized Representative Head, Budget Unit/Authorized Representative

Date Date

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