No:
Date: 11/07/2014
Responsibility Center
LIQUIDATION REPORT
Carigara, Leyte
LGU
PARTICULARS
AMOUNT
Liquidation of Cash Advance while on Official Travel to Cebu under Check No.
0000006075 dated October 21, 2014
TOTAL AMOUNT SPENT
AMOUNT OF CASH ADVANCE PER DV NO _________ Dated __________
AMOUNT REFUNDED PER O.R. NO. _________ Dated _________
AMOUNT TO BE REIMBURSED
Submitted by:
FRANCISCO S. CAUBALEJO
Received by:
JULIET R. HANOPOL
Municipal Accountant
__________________
Date
5,610.00
5,610.00
5,610.00
1,164.64