CASH/CHECK DISBURSEMENTS REGISTER

Entity Name: DEPARTMENT OF EDUCATION - MASBATE PROVINCE Name of Accountable Officer:

Sub-Office/District/Division: AROROY EAST DISTRICT Official Designation:
Municipality/City/Province: AROROY, MASBATE Station:
Fund Cluster: Register No.:

Advances for
Operating Expenses
(19901010) OTHER
OFFICE SUPPLIES OTHER INTERNET
TRAVELLING
Amount EXPENSES
SUPPLIES AND GENERAL SUBS OTHERS
DV/ Payroll/ EXPENSES MATERIALS SERVICES EXPENSES
Date Particulars
Check No. EXPENSES
UACS
Account
Cash Advance Gross Amount Tax Withheld Payments Balance 50201010-00 50203010-02 50203990-00 50212990-99 50205030-00 Object Amount
Description
Code

Balance of Previous MOOE Cash Advance

New Release of MOOE Cash Advance
Total Available MOOE -

- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -

Totals - - - - - - - - - - -
SUMMARY OF CREDITS:
Advances to Officers & Employees 19901010-00 -
Advances to Officers & Employees 19901010-00 -
Due to BIR 20201010-00 -
TOTAL CREDITS -
#DIV/0! of Liquidation (Previous)
#DIV/0! of Liquidation (New)
CERTIFIED CORRECT: RECEIVED / REVIEWED BY: The total of the 'Advances for Operating Expenses - Payments' column must always be
equal to the sum of the totals of the 'Breakdown of Payments' columns.
APPROVED BY:

Signature over Printed Name Signature over Printed Name ROMEO T. ATACADOR, CPA
School Head MOOE EXPRESS Bookkeeper Accountant III
Date: Date: Date:
 CASH/CHECK DISBURSEMENTS REGISTER
Entity Name: DEPARTMENT OF EDUCATION - MASBATE PROVINCE Name of Accountable Officer:
Sub-Office/District/Division: AROROY EAST DISTRICT Official Designation:
Municipality/City/Province: AROROY, MASBATE Station:
Fund Cluster: Register No.:

Advances for
Operating Expenses
(19901010) OTHER
OFFICE SUPPLIES OTHER INTERNET
TRAVELLING
Amount EXPENSES
SUPPLIES AND GENERAL SUBS OTHERS
DV/ Payroll/ EXPENSES MATERIALS SERVICES EXPENSES
Date Particulars
Check No. EXPENSES
UACS
Account
Cash Advance Gross Amount Tax Withheld Payments Balance 50201010-00 50203010-02 50203990-00 50212990-99 50205030-00 Object Amount
Description
Code
 Appendix 32
Republic of the Philippines Fund Cluster :
Department of Education
Region V
DIVISION OF MASBATE PROVINCE
Rodeo Road, Masbate City
Date
DV :
DISBURSEMENT VOUCHER No. :

Mode of
MDS Check Commercial Check ADA Others (Please specify)
Payment

TIN/Employee No.: ORS/BURS No.:

Payee ROSEMARIE V. SALVACION
915-908162-000

Address Tara St., Pating ( Pob.), 2nd Dist., City of Masbate

Particulars Responsibility Center MFO/PAP Amount

To: Payment Reimbursement of:

purchases of office supplies as per supporting documents

attached in the amount of… P 40,029.20

Gross Amount 42,295.00

VAT:
1% EWT 377.63
5% BT 1,888.17 2,265.80
Amount Due 40,029.20

P 40,029.20
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

JOSE ARIEL A. ROSAS

Principal / School Head

B. Accounting Entry:
Account Title UACS Code Debit Credit

OFFICE SUPPLIES EXPENSES 50203010-02 42,295.00

ADVANCES FOR OPERATING EXPENSES 19901010-00 40,029.20
DUE TO BIR 20201010-00 2,265.80

C. Certified: D. Approved for Payment:

Cash available
Subject to Authority to Debit Account (when applicable)
Suppo
Signature Signature

Printed Name FERLY A. ODTUJAN Printed Name JOSE ARIEL A. ROSAS

Position Bookkeeper Position Principal / School Head
Date Date
E. Receipt of Payment JEV No.:
Date : Bank Name & Account Number:
Check/ ADA
No. :
0-00741-625-6
Date : Printed Name: Date:
Signature :
ROSEMARIE V. SALVACION
Official Receipt No. & Date/Other Documents
 Appendix 32
Republic of the Philippines Fund Cluster :
Department of Education
Region V
DIVISION OF MASBATE PROVINCE
Rodeo Road, Masbate City
Date
DV :
DISBURSEMENT VOUCHER No. :

Mode of
MDS Check Commercial Check ADA Others (Please specify)
Payment

TIN/Employee No.: ORS/BURS No.:

Payee

Address

Particulars Responsibility Center MFO/PAP Amount

To: Payment Reimbursement of:

tarpaulin printing services as per supporting documents
attached in the amount of… P 9,375.00

Gross Amount 10,000.00

VAT:
2% EWT 178.57
5% BT 446.43 625.00
Amount Due 9,375.00

P 9,375.00
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

Principal / School Head

B. Accounting Entry:
Account Title UACS Code Debit Credit

PRINTING AND PUBLICATION EXPENSES 50299020-00 10,000.00

ADVANCES FOR OPERATING EXPENSES 19901010-00 9,375.00
DUE TO BIR 20201010-00 625.00

C. Certified: D. Approved for Payment:

Cash available
Subject to Authority to Debit Account (when applicable)
Suppo
Signature Signature

Printed Name Printed Name

Position Bookkeeper Position Principal / School Head

Date Date
E. Receipt of Payment JEV No.:
Date : Bank Name & Account Number:
Check/ ADA
No. :

Date : Printed Name: Date:

Signature :

Official Receipt No. & Date/Other Documents

 Appendix 32
Republic of the Philippines Fund Cluster :
Department of Education
Region V
DIVISION OF MASBATE PROVINCE
Rodeo Road, Masbate City
Date
DV :
DISBURSEMENT VOUCHER No. :

Mode of
MDS Check Commercial Check ADA Others (Please specify)
Payment

TIN/Employee No.: ORS/BURS No.:

Payee NELBA P. MONTEALEGERE

Address Poblacion, Aroroy, Masbate

Particulars Responsibility Center MFO/PAP Amount

To: Payment Reimbursement of:

purchases of office supplies as per supporting documents
attached in the amount of… P 40,603.20

Gross Amount 42,295.00

VAT:
1% EWT 422.95
3% BT 1,268.85 1,691.80
Amount Due 40,603.20

P 40,603.20
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

JOSE ARIEL A. ROSAS

Principal / School Head

B. Accounting Entry:
Account Title UACS Code Debit Credit

OFFICE SUPPLIES EXPENSES 50203010-02 42,295.00

ADVANCES FOR OPERATING EXPENSES 19901010-00 40,603.20
DUE TO BIR 20201010-00 1,691.80

C. Certified: D. Approved for Payment:

Cash available
Subject to Authority to Debit Account (when applicable)
Suppo
Signature Signature

Printed Name FERLY A. ODTUJAN Printed Name JOSE ARIEL A. ROSAS

Position Bookkeeper Position Principal / School Head
Date Date
E. Receipt of Payment JEV No.:
Date : Bank Name & Account Number:
Check/ ADA
No. :
0-00741-625-6
Date : Printed Name: Date:
Signature :

Official Receipt No. & Date/Other Documents

 Appendix 32
Republic of the Philippines Fund Cluster :
Department of Education
Region V
DIVISION OF MASBATE PROVINCE
Rodeo Road, Masbate City
Date
DV :
DISBURSEMENT VOUCHER No. :

Mode of
MDS Check Commercial Check ADA Others (Please specify)
Payment

TIN/Employee No.: ORS/BURS No.:

Payee

Address

Particulars Responsibility Center MFO/PAP Amount

To: Payment Reimbursement of:

tarpaulin printing services as per supporting documents
attached in the amount of… P 9,500.00

Gross Amount 10,000.00

VAT:
2% EWT 200.00
3% BT 300.00 500.00
Amount Due 9,500.00

P 9,500.00
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

Principal / School Head

B. Accounting Entry:
Account Title UACS Code Debit Credit

PRINTING AND PUBLICATION EXPENSES 50299020-00 10,000.00

ADVANCES FOR OPERATING EXPENSES 19901010-00 9,500.00
DUE TO BIR 20201010-00 500.00

C. Certified: D. Approved for Payment:

Cash available
Subject to Authority to Debit Account (when applicable)
Suppo
Signature Signature

Printed Name Printed Name

Position Bookkeeper Position Principal / School Head

Date Date
E. Receipt of Payment JEV No.:
Date : Bank Name & Account Number:
Check/ ADA
No. :

Date : Printed Name: Date:

Signature :

Official Receipt No. & Date/Other Documents

 Appendix 32
Republic of the Philippines Fund Cluster :
Department of Education
Region V
DIVISION OF MASBATE PROVINCE
Rodeo Road, Masbate City
Date
DV :
DISBURSEMENT VOUCHER No. :

Mode of
MDS Check Commercial Check ADA Others (Please specify)
Payment

TIN/Employee No.: ORS/BURS No.:

Payee

Address

Particulars Responsibility Center MFO/PAP Amount

To: Payment Reimbursement of:

Amount Due P -
A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

Principal / School Head

B. Accounting Entry:
Account Title UACS Code Debit Credit

OFFICE SUPPLIES EXPENSES 50203010-02 -

ADVANCES FOR OPERATING EXPENSES 19901010-00 -

C. Certified: D. Approved for Payment:

Cash available
Subject to Authority to Debit Account (when applicable)
Suppo
Signature Signature

Printed Name Printed Name

Position Bookkeeper Position Principal / School Head

Date Date
E. Receipt of Payment JEV No.:
Date : Bank Name & Account Number:
Check/ ADA
No. :

Date : Printed Name: Date:

Signature :

Official Receipt No. & Date/Other Documents

 Appendix 63

REQUISITION AND ISSUE SLIP

Entity Name : TIGBAO INTEGRATED SCHOOL Fund Cluster :

Division : MASBATE PROVINCE RCC:

Office : TIGBAO INTEGRATED SCHOOL RIS No. : 2023-
Requisition Stock Available? Issue
Stock No. Unit Description Quantity Yes No Quantity Remarks
1 Box A4 Bondpaper 5 / To purchase
2 Box Long Bondpaper 2 / To purchase
3 pacs A4 worx paper 50 / To purchase
4 packs Long worx paper 30 / To purchase
5 meter Silk fabric (Gold) 30 / To purchase
6 meter Silk fabric (White) 30
7 pcs Gold Medal 20
pcs Plastic envelop 100
Certificate Holder 38
Styrofoam Thin 15
Thumbtacks 1
Pins 1
1/4 Acrylic paint black 6
1/4 Acrylic paint yellow 6
Parchment Paper 1
Bronze Medal 70
Silver Medal 25
long expanded envelop 17

Purpose:

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

Signature :
Printed Name : MARK D. CABALLERO JOSE ARIEL A. ROSAS
Designation : School Property Teachers School Head
Date :
15
 Appendix 60

PURCHASE REQUEST

Entity Name TIGBAO INTEGRATED SCHOOL Fund Cluster:

Office/Section : PR No.: 2023 Date:
Responsibility Center Code:
Stock/
Property Unit Item Description Quantity Unit Cost Total Cost
No.

1 Box A4 Bondpaper 5 1,450.00 7,250.00

2 Box Long Bondpaper 2 1475 2,950.00

3 pacs A4 worx paper 50 55.00 2,750.00
4 packs Long worx paper 15 56.00 840.00
5 meter Silk fabric (Gold) 30 138.00 4,140.00
Silk fabric (White) 30 138.00 4,140.00
Gold Medal 20 95.00 1,900.00
Plastic envelop 100 23.00 2,300.00
Certificate Holder 38 68.00 2,584.00
Styrofoam Thin 15 125.00 1,875.00
Thumbtacks 1 450.00 450.00
Pins 1 225.00 225.00
1/4 Acrylic paint black 6 38.00 228.00
1/4 Acrylic paint yellow 6 38.00 228.00
Parchment Paper 1 900.00 900.00
Bronze Medal 70 95.00 6,650.00
Silver Medal 25 95.00 2,375.00
long expanded envelop 17 30.00 510.00
0
0
0
0

TOTAL 42,295.00
Purpose: For the Printing of 1st periodical Test of the lerners

Requested by: Approved by:

Signature:
Printed
Name:
MARK D. CABALLERO JOSE ARIEL A. ROSAS
Designatio School Property Teachers School Head
n:
-
 Republika ng Pilipinas
Kagawaran ng Edukasyon
Region V
DIVISION OF MASBATE PROVINCE
Rodeo Road, Masbate City

AROROY EAST DISTRICT

BIDS AND AWARDS COMMITTEE
TIGBAO INTEGRATED SCHOOL
MASBATE

BAC RESOLUTION TO EMPLOY SHOPPING AS ALTERNATIVE MODE OF PROCUREMENT

FOR PURCHASE OF SCHOOL OFFICE SUPPLIES USED BY
TIGBAO INTEGRATED SCHOOL , AROROY WEST DISTRICT
RESOLUTION NO , S. 2023

WHEREAS, the Committee requested to the School Head for the purchase of school
OFFICE SUPPLIES of TIGBAO INTEGRATED SCHOOL , Aroroy West District;

WHEREAS, the Supply Officer requested the purchase of schoo OFFICE SUPPLIES
quested items;

WHEREAS, the Committee deliberated, voted and decided to use negotiated procurement through shopping
since the amount involved does not exceed the threshold in this procurement;

WHEREAS, the BAC considered the time constraint and the urgency of the procurement, the committee
recommended the employment of negotiated procurement under shopping as the alternative mode of procurement pursuant
the provisions of RA 9184.

NOW, THEREFORE, foregoing premises considered, we members of the Bids and Awards Committee, hereby
resolve as it is hereby RESOLVED.

1. To employ shopping as the alternative method of procurement as specified pursuant to

Section 52 (1) of Rule XVI in the revised implementing Rules and Regulations of RA 9184; and
2. To recommend such alternative method of procurement to the Schools Division Superintendent
as Head in the Procuring Entity for his approval;

RESOLVED this day of at the

TIGBAO INTEGRATED SCHOOL , Aroroy West District, Masbate.

KHRISTINE DEWIE D. LAYSON AN JEANEN C. FAJARDO MOLINA D. CABALLERO

Teacher-lll Teacher-III Teacher I
BAC Member BAC Member BAC Member

GOLDIE R. LOPERA ROMEO R. BARNES

Teacher I Teacher I
BAC Member BAC Chairman

APPROVED:

JOSE ARIEL A. ROSAS

School Head
Date:
 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Masbate

Reynelbz Office and School Supplies

Poblacion, Aroroy, Masbate

Sir/Madam:

Please quote your lowest prices for the supplies/materials listed below to be delivered to the Office of the
TIGBAO INTEGRATED SCHOOL , subject to the usual inspection by the
EMELYN S. TOLEDO or his authorized representative.

Quotation shall be construed to mean that the bidder guarantees, to furnish the supplies/materials and fully conforming
to the specifications and to abide by the terms and conditions, government taxes, imports and/or duties, if any and all incidental expenses.

When the invitation to bid calls for more than one item, quotations are to be individually treated and the bidder shall be compelled
to accept the awards of which items may be selected by the government. An all non-offer, however, may be considered and the discretion of

The government reserves the right to reject any of all bid prices offered, to waive any defect or to accept such prices as may be
found advantageous to the government.

Very truly yours,

ROMEO R. BARNES
BAC CHAIRMAN

I HEREBY QUOTE the following

QTY. UNIT ARTICLES Unit Price TOTAL
5 Box A4 Bondpaper -
2 Box Long Bondpaper -
50 pacs A4 worx paper -
15 packs Long worx paper -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Signature over printed name

 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Masbate

LCC Aroroy
Rosero St. Masbate City

Sir/Madam:

Please quote your lowest prices for the supplies/materials listed below to be delivered to the Office of the
TIGBAO INTEGRATED SCHOOL , subject to the usual inspection by the
EMELYN S. TOLEDO or his authorized representative.

Quotation shall be construed to mean that the bidder guarantees, to furnish the supplies/materials and fully conforming
to the specifications and to abide by the terms and conditions, government taxes, imports and/or duties, if any and all incidental expenses.

When the invitation to bid calls for more than one item, quotations are to be individually treated and the bidder shall be compelled
to accept the awards of which items may be selected by the government. An all non-offer, however, may be considered and the discretion of

The government reserves the right to reject any of all bid prices offered, to waive any defect or to accept such prices as may be
found advantageous to the government.

Very truly yours,

ROMEO R. BARNES
BAC CHAIRMAN

I HEREBY QUOTE the following

QTY. UNIT ARTICLES Unit Price TOTAL
5 Box A4 Bondpaper -
2 Box Long Bondpaper -
3 pacs A4 worx paper -
4 packs Long worx paper -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Signature over printed name

 Republic of the Philippines
Department of Education
Region V
DIVISION OF MASBATE
Masbate

Paper Queen
POBLACION, AROROY, MASBATE

Sir/Madam:

Please quote your lowest prices for the supplies/materials listed below to be delivered to the Office of the
TIGBAO INTEGRATED SCHOOL , subject to the usual inspection by the
EMELYN S. TOLEDO or his authorized representative.

Quotation shall be construed to mean that the bidder guarantees, to furnish the supplies/materials and fully conforming
to the specifications and to abide by the terms and conditions, government taxes, imports and/or duties, if any and all incidental expenses.

When the invitation to bid calls for more than one item, quotations are to be individually treated and the bidder shall be compelled
to accept the awards of which items may be selected by the government. An all non-offer, however, may be considered and the discretion of

The government reserves the right to reject any of all bid prices offered, to waive any defect or to accept such prices as may be
found advantageous to the government.

Very truly yours,

ROMEO R. BARNES
BAC CHAIRMAN

I HEREBY QUOTE the following

QTY. UNIT ARTICLES Unit Price TOTAL
5 Box A4 Bondpaper -
2 Box Long Bondpaper -
3 pacs A4 worx paper -
4 packs Long worx paper -
5 meter Silk fabric (Gold) -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -
Signature over printed name
 ABSTRACT OF CANVASS FOR FURNISHING AND DELIVERING SUPPLY MATERIALS FOR THE OFFICE OF THE PRINCIPAL
Reynelbz Office
ITEM and School NAME OF BIDDERS Accepted
QTY. Unit ARTICLES Previous Price
NO. Supplies LCC Aroroy Paper Queen Price
1 5 Box A4 Bondpaper 7,250.00 7,265.00 7,277.50 7,265.00 7,277.50
2 2 Box Long Bondpaper 2,950.00 2,956.00 2,962.00 2,956.00 2,950.00
3 50 pacs A4 worx paper 2,750.00 2,900.00 3,050.00 2,900.00 2,750.00
4 15 packs Long worx paper 840.00 885.00 930.00 885.00 840.00
5 30 meter Silk fabric (Gold) 4,140.00 4,230.00 4,320.00 4,230.00 4,140.00

17,930.00 18,236.00 18,539.50

TOTAL 17,957.50

MARK D. CABALLERO EMELYN S. TOLEDO FERLY A. ODTUJAN

School Property Designate Inspector Designate Bookkeeper Designate

AWARD TO:
ROSEMARIE V. SALVACION JOSE ARIEL A. ROSAS
Printed Name of Supplier Principal / School Head
 Republika ng Pilipinas
Kagawaran ng Edukasyon
Region V
DIVISION OF MASBATE PROVINCE
Rodeo Road, Masbate City

AROROY EAST DISTRICT

BIDS AND AWARDS COMMITTEE
TIGBAO INTEGRATED SCHOOL
MASBATE

BAC RESOLUTION DECLARING THE LOWEST CALCULATED AND RESPONSIVE BID FOR THE
PROCUREMENT OF OTHER SUPPLIES AND EXPENSES
RESOLUTION NO. , S. 2023

WHEREAS, the TIGBAO INTEGRATED SCHOOL , Aroroy East District

is in need of OTHER SUPPLIES AND EXPENSES

WHEREAS, the School Head, JOSE ARIEL A. ROSAS has an available

fund for the MOOE of TIGBAO INTEGRATED SCHOOL

WHEREAS, considering the unforeseen contingency and the urgency of the procurement for
OTHER SUPPLIES AND EXPENSES , the committee recommended the employment of negotiated
procurement for small value procurement as the alternative mode of procurement which was approved by the School Head.

WHEREAS, the Committee, ensuring a fair and equal opportunity of interested and qualified bidders
in the locality, posted the Request for Quotation in a conspicuous places in TIGBAO INTEGRATED SCHOOL

WHEREAS, as a result of that invitations and posting, three (3) bidder submitted quotations
on the Office of the BAC Chair;

WHEREAS, at the opening of quotations, the following bidders had their corresponding bid offer, to wit:
Reynelbz
Office and
Unit Quantity Description LCC Aroroy Paper Queen
School
Supplies
Box 5 A4 Bondpaper 7,250.00 7,265.00 7,277.50
Box 2 Long Bondpaper 2,950.00 2,956.00 2,962.00
pacs 50 A4 worx paper 2,750.00 2,900.00 3,050.00
packs 15 Long worx paper 840.00 885.00 930.00

TOTAL 13,790.00 14,006.00 14,219.50

WHEREAS, the Bids & Awards Committee declared Reynelbz Office and School Supplies
the lowest calculated bidders on the same day.

WHEREAS, the Committee chose Reynelbz Office and School Supplies

for it has a recently awarded quotation for OTHER SUPPLIES AND EXPENSES .

WHEREAS, considering the quoted price of the lowest bidder and the prevailing price
this procurement is most advantageous to the government;

NOW, THEREFORE, foregoing premises considered, we, members of the Bids and Awards
Committee hereby resolve, as it is hereby RESOLVED to declare Reynelbz Office and School Supplies
as the lowest calculated and responsive bidder.

RESOLVED this day of at the

TIGBAO INTEGRATED SCHOOL , Aroroy East District, Masbate.

KHRISTINE DEWIE D. LAYSON AN JEANEN C. FAJARDO MOLINA D. CABALLERO

Teacher I Teacher I Teacher I
BAC Member BAC Member BAC Member

GOLDIE R. LOPERA ROMEO R. BARNES

Teacher I Teacher I
BAC Member BAC Chairman

APPROVED:

JOSE ARIEL A. ROSAS

School Head
Date:
 Appendix 61

PURCHASE ORDER

Entity Name

Supplier : Reynelbz Office and School Supplies P.O. No. :

Address : Poblacion ,Aroroy, Masbate Date :
TIN : 749-965-658-000 Mode of Procurement : Shopping
Gentlemen:
Please furnish this Office the following articles subject to the terms and conditions contained herein:

Place of Delivery : Delivery Term :

Date of Delivery : Payment Term :
Stock/
Property Unit Description Quantity Unit Cost Amount
No.
1 Box A4 Bondpaper 5
2 Box Long Bondpaper 2
3 pacs A4 worx paper 50
4 packs Long worx paper 15
5 meter Silk fabric (Gold) 30

TOTAL -
Total Amount in Words: Twnety Thousand pesos only.

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

Conforme: Very truly yours,

NELBA P. MONTEALEGERE JOSE ARIEL A. ROSAS

Signature over Printed Name of Supplier Signature over Printed Name of School Head
Date:
Designation

Fund Cluster : MOOE ORS/BURS No. :

Funds Available : Date of the ORS/BURS:
Amount :
Signature over Printed Name of Bookkeeper
 CERTIFICATE OF DELIVERY

To Whom It May Concern:

I HEREBY CERTIFY that all articles on this voucher have been delivered to the office of the
SCHOOLS DIVISION SUPERINTENDENT , Masbate, delivered by Reynelbz Office and School Supplies
under contract or verbal agreement to measurement as listed herein; that all of said articles
(except as otherwise specifically noted on the voucher) as new and first hand; and that accordingly
they have been accepted by me in my capacity as Supply officer II of the office of the
Department of Education for and behalf of the Schools Division Superintendent, Masbate and that
the contractor or dealer is entitled to payment therefore.

MARK D. CABALLERO
School Property Officer- Designated
Date:

JOSE ARIEL A. ROSAS

Principal/School Head
Date:
 Appendix 62

INSPECTION AND ACCEPTANCE REPORT

Entity Name : TIGBAO INTEGRATED SCHOOL Fund Cluster : MOOE

Supplier : Reynelbz Office and School Supplies IAR No. :

PO No./Date : Date :
Requisitioning
TIGBAO INTEGRATED SCHOOL Invoice No.:
Office/Dept. :
Responsibility
Date :
Center Code :

Stock/
Description Unit Quantity
Property No.

1 A4 Bondpaper Box 5
2 Long Bondpaper Box 2
3 A4 worx paper pacs 50
4 Long worx paper packs 15

INSPECTION ACCEPTANCE
Date Inspected: Date Received :

✘ Inspected, verified and found in order as ✘ Complete

to quantity and specifications
Partial (pls. specify quantity)
MA. ARLENE T. VECINO
School Inspectorate Team Member

ERIC A. PAREJA MARK D. CABALLERO

School Inspectorate Team Provisional Member Supply and/or Property Custodian

IMELDA S. OLIVA
School Inspectorate Team Leader
 Department of Education
DISTRICT: AROROY WEST DISTRICT DATE:
SCHOOL: TIGBAO INTEGRATED SCHOOL
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
1 pacs A4 worx paper 50 - -
2 packs Long worx paper 15 - -

-
-
-
-
-
-
-
-
-
-
-
TOTAL -

MARK D. CABALLERO MARK D. CABALLERO

Printed Name of Requisitioner School Property Designate

JOSE ARIEL A. ROSAS MARK D. CABALLERO

Principal / School Head Signature of Requisitioner
 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

 Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

 Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

 Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -

Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

Department of Education
DISTRICT: DATE:
SCHOOL:
LOCAL RIS
ITEM UNIT ITEM DESCRIPTION QUANTITY UNIT PRICE TOTAL
-
-
-
-
TOTAL -
Printed Name of Requisitioner School Property Designate

Principal / School Head Signature of Requisitioner

 Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name: TIGBAO INTEGRATED SCHOOL

Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
5 Box 1,450.00 7,250.00 A4 Bondpaper
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL 7,250.00
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:
 Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:
 Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

 Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -
Received from: Received by:
 Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
TOTAL -
Received from: Received by:
 Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
 TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
 -
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:
 Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
 Date: Date:
Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

 Position/Office Position/Office
Date: Date:
Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

 Position/Office Position/Office
Date: Date:
Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:
 Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:
Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:
 Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:
Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:
 Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:
Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:

Appendix 59
INVENTORY CUSTODIAN SLIP

Entity Name:
Fund Cluster : MOOE ICS No :

Amount Estimated
Inventory
QTY. Unit Description Useful
Unit Cost Total Cost Item No.
Life
-
-
-
-
-
-
TOTAL -
Received from: Received by:

Signature Over Printed Name Signature Over Printed Name

Position/Office Position/Office
Date: Date:
 Republic of the Philippines
For BIR BCS/ Department of Finance
Use Only Item: Bureau of Internal Revenue
BIR Form No.
Certificate of Creditable Tax
2307
January 2018 (ENCS)
Withheld at Source 2307 01/18ENCS
Fill in all applicable spaces. Mark all appropriate boxes with an "X".

1 For the Period From (MM/DD/YYYY) To (MM/DD/YYYY)

Part I – Payee Information

2 Taxpayer Identification Number (TIN) 749 - 965 - 658 - 0000

3 Payee’s Name (Last Name, First Name, Middle Name for Individual OR Registered Name for Non-Individual)
MONTEALEGERE,NELBA P.
4 Registered Address 4A ZIP Code
Tara St., Pating ( Pob.), 2nd Dist., City of Masbate
5 Foreign Address, if applicable

Part II – Payor Information

6 Taxpayer Identification Number (TIN) 863 - 958 - 881 - 0 0 0 0 0

7 Payor’s Name (Last Name, First Name, Middle Name for Individual OR Registered Name for Non-Individual)
DEPED MASBATE PROVINCE
8 Registered Address 8A ZIP Code
RODEO RD., BRGY. CENTRO, MASBATE CITY, MASBATE, PHILIPPINES 5400
Part III – Details of Monthly Income Payments and Taxes Withheld
AMOUNT OF INCOME PAYMENTS
Income Payments Subject to Expanded Tax Withheld for the
ATC 1st Month of the 2nd Month of the 3rd Month of the
Withholding Tax Total Quarter
Quarter Quarter Quarter
OFFICE SUPPLIES 20000 200

Total
Money Payments Subject to
Withholding of Business Tax
(Government & Private)
OFFICE SUPPLIES 20000 600

Total 800

We declare under the penalties of perjury that this certificate has been made in good faith, verified by us, and to the best of our knowledge and belief, is true and
correct, pursuant to the provisions of the National Internal Revenue Code, as amended, and the regulations issued under authority thereof. Further, we give our
consent to the processing of our information as contemplated under the *Data Privacy Act of 2012 (R.A. No. 10173) for legitimate and lawful purposes.

JOSE ARIEL A. ROSAS / SCHOOL HEAD / 9246310140

Signature over Printed Name of Payor/Payor’s Authorized Representative/Tax Agent
(Indicate Title/Designation and TIN)
Tax Agent Accreditation No./ Date of Issue Date of Expiry
Attorney’s Roll No. (if applicable) (MM/DD/YYYY) (MM/DD/YYYY)
CONFORME:

NELBA P. MONTEALEGERE / PROPRIETOR / 749-965-658-000

Signature over Printed Name of Payee/Payee’s Authorized Representative/Tax Agent
(Indicate Title/Designation and TIN)
Tax Agent Accreditation No./ Date of Issue Date of Expiry
Attorney’s Roll No. (if applicable) (MM/DD/YYYY) (MM/DD/YYYY)
*NOTE: The BIR Data Privacy is in the BIR website (www.bir.gov.ph)
 SCHEDULES OF ALPHANUMERIC TAX CODES
ATC ATC
A Income Payments subject to Expanded Withholding Tax A Income Payments subject to Expanded Withholding Tax
Individual Corporation Individual Corporation
Professional (Lawyers, CPAs, Engineers, etc.) Payment by the General Professional Partnerships (GPPs) to its partners
If gross income for the current year did not exceed P 3M WI010 If gross income for the current year did not exceed P 720,000 WI152
If gross income is more than P 3M or VAT Registered regardless of amount WI011 If gross income exceeds P 720,000 WI153
Professional (Lawyers, CPAs, Engineers, etc.) Income payments made by credit card companies WI156 WC156
If gross income for the current year did not exceed P 720,000 WC010 Additional income payments to government personnel from importers, shipping
WI159
If gross income exceeds P 720,000 WC011 and airline companies or their agents for overtime services
Professional entertainers such as, but not limited to actors and actresses, singers, Income payments made by the government and government-owned and
lyricist, composers, emcees controlled corporations (GOCCs) to its local/resident suppliers of goods WI640 WC640
If gross income for the current year did not exceed P 3M WI020 other than those covered by other rates of withholding tax
If gross income is more than P 3M or VAT Registered regardless of amount WI021 Income payments made by the government and government-owned and
Professional entertainers such as, but not limited to actors and actresses, singers, controlled corporations (GOCCs) to its local/resident suppliers of services WI157 WC157
lyricists, composers, emcees other than those covered by other rates of withholding tax
If gross income for the current year did not exceed P 720,000 WC020 Income payment made by top withholding agents to their local/resident supplier
WI158 WC158
If gross income exceeds P 720,000 WC021 of goods other than those covered by other rates of withholding tax
Professional athletes including basketball players, pelotaris and jockeys Income payment made by top withholding agents to their local/resident supplier
WI160 WC160
If gross income for the current year did not exceed P 3M WI030 of services other than those covered by other rates of withholding tax
If gross income is more than P 3M or VAT Registered regardless of amount WI031 Commissions, rebates, discounts and other similar considerations paid/granted to
Professional athletes including basketball players, pelotaris and jockeys independent and/or exclusive sales representatives and marketing agents and sub-
If gross income for the current year did not exceed P 720,000 WC030 agents of companies, including multi-level marketing companies
If gross income exceeds P 720,000 WC031 If gross income for the current year did not exceed P 3M WI515
All directors and producers involved in movies, stage, radio, television and musical If gross income is more than P 3M or VAT Registered regardless of amount WI516
productions Commissions, rebates, discounts and other similar considerations paid/ granted
If gross income for the current year did not exceed P 3M WI040 to independent and/or exclusive sales representatives and marketing agents
If gross income is more than P 3M or VAT Registered regardless of amount WI041 and sub-agents of companies, including multi-level marketing companies
All directors and producers involved in movies, stage, radio, television and musical If gross income for the current year did not exceed P 720,000 WC515
productions If gross income exceeds P 720,000 WC516
If gross income for the current year did not exceed P 720,000 WC040 Gross payments to embalmers by funeral parlors WI530
If gross income exceeds P 720,000 WC041 Payments made by pre-need companies to funeral parlors WI535 WC535
Management and technical consultants Tolling fees paid to refineries WI540 WC540
If gross income for the current year did not exceed P 3M WI050 Income payments made to suppliers of agricultural products in excess
WI610 WC610
If gross income is more than P 3M or VAT Registered regardless of amount WI051 of cumulative amount of P 300,000 within the same taxable year
Management and technical consultants Income payments on purchases of minerals, mineral products and quarry
If gross income for the current year did not exceed P 720,000 WC050 such as but not limited to silver, gold, marble, granite, gravel, sand, boulders WI630 WC630
If gross income exceeds P 720,000 WC051 and other mineral products except purchases by Bangko Sentral ng Pilipinas
Business and bookkeeping agents and agencies Income payments on purchases of minerals, mineral products and quarry
If gross income for the current year did not exceed P 3M WI060 resources by Bangko Sentral ng Pilipinas (BSP) from gold miners/suppliers under WI632 WC632
If gross income is more than P 3M or VAT Registered regardless of amount WI061 PD 1899, as amended by RA No. 7076
Business and bookkeeping agents and agencies On gross amount of refund given by MERALCO to customers with
WI650 WC650
If gross income for the current year did not exceed P 720,000 WC060 active contracts as classified by MERALCO
If gross income exceeds P 720,000 WC061 On gross amount of refund given by MERALCO to customers with
WI651 WC651
Insurance agents and insurance adjusters terminated contracts as classified by MERALCO
If gross income for the current year did not exceed P 3M WI070 On gross amount of interest on the refund of meter deposit whether paid directly to
If gross income is more than P 3M or VAT Registered regardless of amount WI071 the customers or applied against customer’s billings of Residential and General
WI660 WC660
Insurance agents and insurance adjusters Service customers whose monthly electricity consumption exceeds 200 kwh as
If gross income for the current year did not exceed P 720,000 WC070 classified by MERALCO
If gross income exceeds P 720,000 WC071 On gross amount of interest on the refund of meter deposit whether paid directly to
Other recipients of talent fees the customers or applied against customer’s billings of Non- Residential customers
WI661 WC661
If gross income for the current year did not exceed P 3M WI080 whose monthly electricity consumption exceeds 200 kwh as classified by
If gross income is more than P 3M or VAT Registered regardless of amount WI081 MERALCO
Other recipients of talent fees On gross amount of interest on the refund of meter deposit whether paid directly to
If gross income for the current year did not exceed P 720,000 WC080 the customers or applied against customer’s billings of Residential and General
WI662 WC662
If gross income exceeds P 720,000 WC081 Service customers whose monthly electricity consumption exceeds 200 kwh as
Fees of directors who are not employees of the company classified by other electric Distribution Utilities (DU)
If gross income for the current year did not exceed P 3M WI090 On gross amount of interest on the refund of meter deposit whether paid directly to
If gross income is more than P 3M or VAT Registered regardless of amount WI091 the customers or applied against customer’s billings of Non-Residential customers
WI663 WC663
Rentals: On gross rental or lease for the continued use or possession of personal whose monthly electricity consumption exceeds 200 kwh as classified by other
property in excess of Ten thousand pesos (P 10,000) annually and real property electric Distribution Utilities (DU)
WI100 WC100
used in business which the payor or obligor has not taken title or is not taking title, Income payments made by political parties and candidates of local and national
or in which has no equity; poles, satellites, transmission facilities and billboards elections on all their purchases of goods and services related to campaign
Cinematographic film rentals and other payments to resident individuals and expenditures, and income payments made by individuals or juridical persons for WI680 WC680
WI110 WC110
corporate cinematographic film owners, lessors or distributors their purchases of goods and services intended to be given as campaign
Income payments to certain contractors WI120 WC120 contributions to political parties and candidates
Income distribution to the beneficiaries of estates and trusts WI130 Income payments received by Real Estate Investment Trust (REIT) WC690
Gross commissions or service fees of customs, insurance, stock, immigration and Interest income derived from any other debt instruments not within the
WI710 WC710
commercial brokers, fees of agents of professional entertainers and real estate coverage of deposit substitutes and Revenue Regulations No. 14-2012
service Practitioners (RESPs), (i.e. real estate consultants, real estate appraisers Income payments on locally produced raw sugar WI720 WC720
and real estate brokers) Sale of Real Property (Ordinary Asset) 1.50% WI555 WC555
If gross income for the current year did not exceed P 3M WI139 3% WI556 WC556
If gross income is more than P 3M or VAT Registered regardless of amount WI140 5% WI557 WC557
Gross commissions or service fees of customs, insurance, stock, immigration and 6% WI558 WC558
commercial brokers, fees of agents of professional entertainers and real estate B Money Payments Subject to Withholding of Business Tax by Government or Private
service Practitioners (RESPs), (i.e. real estate consultants, real estate appraisers Payor (Individual & Corporate)
and real estate brokers) Persons Exempt from VAT under Sec. 109BB (creditable)-Government Withholding
WB080
If gross income for the current year did not exceed P 720,000 WC139 Agent
If gross income exceeds P 720,000 WC140 Persons Exempt from VAT under Sec. 109BB (creditable)-Private Withholding
WB082
Professional fees paid to medical practitioners (includes doctors of medicine, Agent
doctors of veterinary science & dentists) by hospitals & clinics or paid directly by VAT Withholding on Purchases of Goods (with waiver of privilege to claim input tax
WV012
Health Maintenance Organizations (HMOs) and/or similar establishments credit) (creditable)
If gross income for the current year did not exceed P 3M WI151 VAT Withholding on Purchases of Services (with waiver of privilege to claim input
WV022
If gross income is more than P 3M or VAT Registered regardless of amount WI150 tax credit) (creditable)
Professional fees paid to medical practitioners (includes doctors of medicine
doctors of veterinary science & dentists) by hospitals & clinics or paid directly by
Health Maintenance Organizations (HMOs) and/or similar establishments
If gross income for the current year did not exceed P 720,000 WC151
If gross income exceeds P 720,000 WC150
C Money Payments Subject to Withholding of Business Tax by Government Payor Only
Tax on Carriers and Keepers of Garages WB030 Tax on Other Non-Banks Financial Intermediaries not Performing Quasi-Banking
Franchise Tax on Gas and Utilities WB040 Functions
Franchise Tax on radio & radio & TV broadcasting companies whose annual gross receipts do A. On interest, commissions and discounts from lending activities as well as Income
not exceed P10M & who are not VAT-registered taxpayers WB050 from financial leasing, on the basis of the remaining maturities of instrument from
Tax on Life Insurance Premiums WB070 which such receipt are derived
Tax on Overseas Dispatch, Message or Conversation from the Philippines WB090 - Maturity period is five years or less 5% WB108
Tax on Banks and Non-Bank Financial Intermediaries Performing Quasi Banking Functions - Maturity period is more than five years 1% WB109
A. On interest, commissions and discounts from lending activities as well as income from financial B. On all other items treated as gross income under the code 5% WB110
leasing, on the basis of the remaining maturities of instrument from which such receipt are derived Tax on Cockpits WB140
- Maturity period is five years or less 5% WB301 Tax on amusement places, such as cabarets, night and day clubs, videoke bars, karaoke bars,
WB150
- Maturity period is more than five years 1% WB303 karaoke television, karaoke boxes, music lounges and other similar establishments
B. On dividends and equity shares and net income of subsidiaries 0% WB102 Tax on Boxing exhibitions WB160
C. On royalties, rentals of property, real or personal, profits from exchange Tax on Professional basketball games WB170
and all other items treated as gross income under the Code 7% WB103 Tax on jai-alai and race tracks WB180
D. On net trading gains within the taxable year on foreign currency, debt Tax on sale, barter or exchange of stocks listed and traded through Local Stock exchange WB200
securities, derivatives and other similar financial instruments 7% WB104 Tax on shares of stock sold or exchanged through initial and secondary public offering
Business tax on Agents of Foreign Insurance Companies - Owner of the Property WB121 - Not over 25% 4% WB201
Tax on International Carriers WB130 - Over 25% but not exceeding 33 1/3% 2% WB202
Business Tax on Agents of Foreign Insurance Companies - Insurance Age WB120 - Over 33 1/3% 1% WB203
Business Tax on Agents of Foreign Insurance Companies - Owner of the Property WB121
Tax on International Carriers WB130
REVISED ANNEX E

Republic of the Philippines

Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
Aroroy West District

LOCATOR SLIP

NAME JOHN VINCENT D. REYES

POSITION/DESIGNATION Teacher I
PERMANENT STATION Tigbao Integrated School
PURPOSE OF TRAVEL
(must be supported by
attachments) To submit PO documents to COA Office
PLEASE CHECK Official Business Official Time
DATE AND TIME 6/9/2024
DESTINATION Division Office Masbate Province

JOHN VINCENT D. REYES JOSE ARIEL A. ROSAS

Signature of Requesting Employee Signature of Head of Office

CERTIFICATION

To the concerned:

This is to certify that the above-named DepEd official/personnel has visited or

appeared at this Office/place for the purpose and during the date and time stated above.

Name and Signature:

Position/Designation:
Office:
 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
Aroroy East District

No:

TRAVEL AUTHORITY FOR OFFICIAL TRAVEL

Name
Position / Designation

Permanent Station

Purpose of Travel (must be

supported by attachments)

Host of Activity

Inclusive of Travel Time

Destination

Fund Source

I hereby attest that the information in this form and in the supporting documents attached hereto are true and
correct.

Name and Signature of Requesting Employee Date:

This is to certify that the trip of the requesting employee satisfies all the minimum conditions for authorized
official travel and that alternatives to travel are insufficient for purpose stated herein.

Name and Signature of Recommending Authority Date:

APPROVED

Name and Signature of Approving Authority Date:

 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
Aroroy East District

Name of School

NAME: Position:
SALARY: Station:
PURPOSE OF
TRAVEL:

ITINERARY OF TRAVEL

TIME ALLOTMENT EXPENSES

Means of
DATE Place to be Visited Transportation TOTAL AMOUNT
Departure Arrival Fare Per Diem

TOTAL - - -
I hereby certify that:
(1) I have reviewed the foregoing itinerary;
(2) the travel is necessary to the service;
(3) the period covered is reasonable; and Official/Employee
(4) the expenses claimed are proper.

Bookkeeper-Designate PSDS/Principal/School Head

 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
Aroroy East District

CERTIFICATE OF TRAVEL COMPLETED

Agency Head: RAYMUNDO M. CANTONJOS, CESO VI Station:

Position: SCHOOLS DIVISION SUPERINTENDENT Date:

I certify that I have completed the travel authorized in itinerary of Travel No.
dated, under conditions indicated below:

Strictly in accordance with the approved itinerary.

Cut short as explained below. Excess payment in the amount of P
was refunded under Official Receipt No. dated
Extended as explained below, additional itinerary was submitted.

Other deviations as explained below.

Explanation or justification:

Evidence of travel:
Used tickets Certificate of Appearance Others

Respectfully submitted:

Official/Employee

On evidence and information of which I have knowledge, the travel was actually undertaken.

Immediate Supervisor
 REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF EDUCATION
REGION V
DIVISION OF MASBATE
AROROY EAST DISTRICT

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001- dated June 19, 2017
Name of Employee Employee
No.
Office
Division
Date Particulars Amount (₱)

TOTAL -
Purpose:

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose that above goods
and services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statements
is punishable by law.
Certified Correct: Noted By:
Signature:
Printed Name:
Employee Immediate Supervisor
Date Date
 Appendix 46

REIMBURSEMENT EXPENSE RECEIPT

Entity Name: Fund Cluster : MOOE

Date : RER No. :

RECEIVED from
(Name)
the amount of
(Official Designation)
in payment for
(P )
________________
(In Words)
________________ (in Figures)
_______________
(Payments for subsistence, services,

rental or transportation should show inclusive dates,

purpose, distance, inclusive points of travel, etc.)

PAYEE

Name/Signature:
Address:

WITNESS

Name/Signature:
Address:
 Republika ng Pilipinas
Kagawaran ng Edukasyon
Region V
DIVISION OF MASBATE PROVINCE
Rodeo Rd., Masbate City
Aroroy East District

ACKNOWLEDGEMENT RECEIPT

Date:

This is to acknowledege the receipt of the amount of Pesos Only

(P ) from as payment for the
.

Signature Over Printed Name of Payee

Date:

Signature Over Printed Name of Witness Signature Over Printed Name of Witness
Date: Date:
 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
Aroroy East District

Name of School

Purpose : Breakdown Expenses for the Contestant

TIME Means of Transportation

PLACES TO BE VISITED MEALS AMOUNT
DEPARTURE ARRIVAL transportation Exp. / Fee

Total - - -

Prepared By: Certified Correct:

School Property - Designate Bookkeeper - Designate

Approved:

Principal/School Head
 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
Aroroy East District

Name of School

PAYROLL for Transportation Expenses for

NAME AMOUNT RECEIVED GRADE LEVEL SIGNATURES

Total -

Prepared By: Certified Correct:

School Property - Designate Bookkeeper - Designate

Approved:
Principal/School Head
 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
Aroroy East District

Name of School

Date

AGREEMENT

KNOWN ALL MEN BY THESE PRESENTS:

This AGREEMENT made and entered into by and betwee

School head of Aroroy East District,
Masbate herein referred to as the FIRST PARTY and
of legal age, married and a resident of
Masbate herein referred to the PARTY OF THE SECOND PARTY.

WITNESSETH:

The Party of the FIRST PARTY and of the SECOND PARTY and in consideration
of the Mutual covenant and agreement may be these present, entered into an agreement for

in the amount of (P )

That if the Party of the SECOND PARTY fails to comply in any aspect with the
condition and Stipulation imposed upon them, Party of the FIRST PARTY say without notice
terminate the contract.

IN WITNESS HEREOF, the parties have unto set their hand this
day of 2023, Masbate.

Party of the Second Party

Conforme:

School Head
 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
Aroroy East District

Name of School

Date
JOB ORDER No. 01

The School Principal

Ma'am / Sir:

Section where work will be done:

Requested by:

School Property Teacher-Designate

Date:

Total Estimate Cost:

Materials
Labor
Exception:

Certified Correct:

Bookkeeper-Designate

Approved:

Principal/School Head
 Republic of the Philippines
Department of Education
REGION V
SCHOOLS DIVISION OF MASBATE PROVINCE

SCHOOL: DATE:
DISTRICT: PROJECT COST:
(Indicate here if MOOE, GAD, or
PROJECT TITLE: SOURCE OF FUND:
SBFP)
(Indicate here the activities done, example: COMPLETION
SCOPE OF WORK:
Painting, Masonry, Carpentry, etc.) PERIOD:
(Indicate here the dimensions/area of the
NATURE OF
DESCRIPTION: work to be done, that is, Length x Width x By Administration
IMPLEMENTATION:
Height, & the number of units, if applicable)

PROGRAM OF WORK

Materials Fund Charge /

Materials Unit Qty. Unit Cost
Cost Remarks
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
Materials Cost: -
Labor Cost:
Total Cost: -

Certified Correct: Prepared By:

Bookkeeper Designate School Property Designate

Approved: Noted:

VIRGILIO L. ALBAO
School Head Division Engineer
 Appendix 33
PAYROLL
For the period

Entity Name : Payroll No. :

Fund Cluster : Sheet No.:

We acknowledge receipt of cash shown opposite our name as full compensation for services rendered for the period covered.

COMPENSATIONS DEDUCTIONS
No of:
Serial No. Name Position Employee No. Salaries and Total Net Amount Due Signature of Recipient
Wages-Regular Days Gross Amount Earned Deductions
Mos.

- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
TOTAL - TOTAL -
A CERTIFIED: Services duly rendered as stated. C APPROVED FOR PAYMENT: (Amount in words)
(₱ )

Signature over Printed Name of Authorized Official Date Signature over Printed Name of School Head Date

CERTIFIED: Supporting documents complete and proper; and cash available in the amount of CERTIFIED: Each employee whose name appears on the payroll has been paid the amount as
B ₱ D indicated opposite his/her name E
ORS/
BURS No.
:
Date :
JEV No. :
Signature over Printed Name School Bookkeeper Date Signature over Printed Name of the Disbursing Officer Date :
 Appendix 71

PROPERTY ACKNOWLEDGEMENT RECEIPT

Entity Name :
Fund Cluster: MOOE PAR No.:

Property Date
Quantity Unit Description Amount
Number Acquired

TOTAL -

Signature over Printed Name of Supply and/or

Signature over Printed Name of End User
Property Custodian

Position/Office Position/Office

Date Date
 Appendix 65

WASTE MATERIALS REPORT

Entity Name : Fund Cluster :

Place of Storage : Date :
ITEMS FOR DISPOSAL
Record of Sales
Item Quantity Unit Description Official Receipt
No. Date Amount

TOTAL -
Certified Correct : Disposal Approved :

Signature over Printed Name of Signature over Printed Name of Head of

Supply and/or Property Custodian Agency/Entity or his/her Authorized
Representative

CERTIFICATE OF INSPECTION

I hereby certify that the property enumerated above was disposed of as follows:

Item Destroyed
Item Sold at private sale
Item Sold at public auction
Item Transferred without cost to (Name of the Agency/Entity)

Certified Correct: Witness to Disposal:

Signature over Printed Name of Inspection Officer Signature over Printed Name of Witness
 Baleno Central School
Check Ledger

Date Check Number Particulars Deposit

Bal. Forwarded Initial deposit
February 23, 2021 MOOE - CA (Jan-Mar 2021) 50,000.00
February 28, 2021 10001 Juan Carlos Miguel - Reimbursement
March 01, 2021 10002 PAPERLINE
DUE TO BIR (NON-VAT)
March 10, 2021 10003 TECHNOPET
DUE TO BIR (VAT)
March 15, 2021 10004 SV ANG
April 10, 2021 MOOE - CA (APRIL 2021) 15,000.00
April 11, 2021 10005 PROCOPIO LOZANO - LABOR
April 15, 2021 10006 GOODLIFE - LOAD (APRIL)
April 16, 2021 10007 LOPEZ CENTER
DUE TO BIR (VAT)
withdrawals Balance
500.00
50,500.00
10,000.00 40,500.00
14,400.00 26,100.00
600.00 25,500.00
18,928.57 6,571.43
1,071.43 5,500.00
3,000.00 2,500.00
17,500.00
3,000.00 14,500.00
1,000.00 13,500.00
12,303.57 1,196.43
696.43 500.00