Ap

OBLIGATION REQUEST AND STATUS Serial No. : ____________________________

PAROLE AND PROBATION ADMINISTRATION REGION 2 Date : ________________________________
Entity Name Fund Cluster : 01101
Payee

Office

Address

Responsibility Center Particulars MFO/PAP UACS Object Code Amount

Total
A. B.
Certified: Charges to appropriation/alloment are Certified: Allotment available and obligated
necessary, lawful and under my direct supervision;and for the purpose/adjustment necessary as
supporting documents valid, proper and legal indicated above

Signature : Signature :
Printed Name: Printed Name: GERALD C. TEPPANG
Position : Position : Administrative Officer II
Head, Requesting Office/Authorized Representative Head, Budget Division/Unit/Authorized Representat

Date : _________________________________ Date : _______________________________

C. STATUS OF OBLIGATION
Reference Amount
Balance

ORS/JEV/Check/ Obligation Payable Payment

Date Particulars Not Yet Due
ADA/TRA No.

(a) (b) (c) (a-b)

Obligation ORS No.

Payment ADA/Check
 Appendix 11

Serial No. : ______________________________

Date : _________________________________

Amount

Certified: Allotment available and obligated

GERALD C. TEPPANG
Administrative Officer II
Head, Budget Division/Unit/Authorized Representative

_________________________________

TATUS OF OBLIGATION
Amount
Balance

Due and
Demandable

(b-c)
 Appendix 32

Fund Cluster :
PAROLE AND PROBATION ADMINISTRATION - REGION 2
Entity Name
01
Date :
DISBURSEMENT VOUCHER DV No. :

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

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee

Address

Responsibility
Particulars MFO/PAP Amount
Center

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

Printed Name, Designation and Signature of Supervisor

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment

Cash available
Subject to Authority to Debit Account (when applicable)
Supp
proper

Signature Signature

Printed
BIANCA G. PAGALILAUAN Printed Name BENITA L. MARAMAG
Name
 Accountant 1 Regional Director
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.

Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
0
Official Receipt No. & Date/Other Documents
For OBRS you can only edit the following
1. Payee - Name of payee /Creditor
ex: GERALD C. TEPPANG

2. Office - Name of your office

ex: REGIONAL OFFICE NO. 2

3. Address - Address of payee/creditor

ex: 10 Sampaguita St. Caggay, Tuguegarao City

4. Particulars - Complete details of the claim

ex: To payment of TEV-PSI for the month of January 2015: Total Investigation Report Submitted_______ Total Supervision Report Submitted_________ Total
Kindly attach to DV/ORS the following and arranged as enumerated:
1 Travel Order
2 Certificate of Appearance on Investigation and Supervision
3 Summary of Investigation Reports Submitted (IPCR Table__)
4 Copy of the submitted Investigation Report
5 Summary of Supervision Caseload for the month(Clients duly numbered)
6 Summary of Supervision Reports Submitted (IPCR Table__)
7 Copy of the submitted Supervision Report Submitted

To payment of TEV-OB in attending PRAISE Committee meeting on Jan 15-16, 2015 at Regional Officer per ROSO No 0001 dated 01-02-2016
Kindly attach to DV/ORS the following and arranged as enumerated:
1 ROSO/COSO
2 Duly Approved Itinerary of Travel (Appendix 45)
3 Paper/Electronic plane, boat or bus tickets, boarding pass, terminal fee;
4 Certificate of Appearance/Attendance;
5 Certificate of Travel Completed (CTC) (Appendix 47)

To payment of Electric Bill for the month of January 2015 (Current Reading______ Previous Reading _____ Total KW used _____)
 To payment of Cash Advance for payment of VPAs TEV, 1st Quarter of CY 2016 (C/o Disbursing Officer)
Field Offices will submit the following and arranged as enumerated:
1 Payroll (1 copy)
2 Monthly Report
3 Acknowledgement Receipt by the VPA/ or signed Payroll (3)

To payment of Field Operating Expenses for the period of Jan 1 to Jan 31 2016
1 Summary of Expenses groupped according to nature of expenses i.e., Courier/Postage; Photocopying/Printing etc
2 Official Receipts and other supporting documents arranged following the presentation in the Summary of Expenses
3 For Mailing expenses, attach a duly received Certificate of Mailing
4 For liasoning expenses, attach Itenirary of Travel and Reimbursement Expense Receipt (RER)

5. Under Box A, kindly indicate the name of head of office and its corresponding position i.e MA. CRISTINA C. VIBAR , Chief Probation and Parole Officer; MARIA EMELIE C

6. Kindly Prepare ORS in triplicate copy

For DV you can only edit the following:

1. Payee
2. Address of Payee
3. TIN/Employee No.
4. Particulars
5. Box A: PRINTED NAME OF HEAD OF OFFICE and his corresponding position
6. Kindly prepare DV in 4 copies

IMPORTANT NOTE: THE FORM IS READY FOR PRINTING USING A4 PAPER AND MARGINS ARE ALREADY SET.
ALL SPACES ARE VERY IMPORTANT TO FINANCIAL UNIT AND THERFORE DO NOT MAKE YOUR OWN REVISIONS ON THE FORM. PLS PLS PLS DO NOT MODIFY THE SAID FORM
d_________ Total Client Supervised ______

2016
r; MARIA EMELIE C. CALAGUI, OIC/SPPO

THE SAID FORM

 Appendix 45

ITINERARY OF TRAVEL

Entity Name : PAROLE AND PROBATION ADMINISTRATION

Fund Cluster: 01 No.: _______________

Name : MARY GRACE M. DELA CRUZ Date of Travel : February 2019

Position : SPPO Purpose of Travel :
Official Station : Tuguegarao City PPO
Places to be visited TIME Means of Per
Date Transpor- Others Total
(Destination) Departure Arrival Transportation tation Diem Amount

2/13/2019 OS - Tuguegarao City 7:00am 12:00noon Private Vehicle

Investigation: G. Sibal

2/14/2019 OS - Alcala, Cagayan 6:00am 5:00pm

Investigation: C. Pablo

2/19/2019 OS - Baggao, Cagayan 6:00am 5:00pm

to 2/20/19 Investigation: Limos,
Cabigas and Vallejo

TOTAL
Prepared by :

I certify that : (1) I have reviewed the foregoing MARY GRACE M. DELA CRUZ
itinerary, (2) the travel is necessary to the Signature over Printed Name
service, (3) the period covered is reasonable and
(4) the expenses claimed are proper. Approved by:

BENITA L. MARAMAG
CPPO MARIA EMELIE C. CALAGUI Regional Director
Signature over Printed Name Signature over Printed Name
Immediate Supervisor Agency Head/Authorized Representative
 Appendix 45

ITINERARY OF TRAVEL

Entity Name : PAROLE AND PROBATION ADMINISTRATION

Fund Cluster: 01 No.: _______________

Name : MARY GRACE M. DELA CRUZ Date of Travel :

Position : SPPO Purpose of Travel :
Official Station : Tuguegarao City PPO
Places to be visited TIME Means of Per
Date Transpor- Others Total
(Destination) Departure Arrival Transportation tation Diem Amount

1/9/2019 OS - Tuao, Cagayan 6:00am 5:00pm Private Vehicle

Investigation: Reylubong
Supervision: Taliping,
Lorenzo, Nofran and
Pamittan

1/10/2019 OS - Penablanca, Cagayan 6:00am 5:00pm

Investigation: Lopez
Supervision: Banatao and
Matalang

1/15/2019 OS - Baggao, Cagayan 6:00am 5:00pm

Investigation: Tumaneng
and Lacaba
Supervision: Mayos,Salas,
Bunuan, Tejero and Molina

1/16/2019 OS - Tuguegarao, Cagayan 6:00am 5:00pm

Investigation: Tungcul and
Ancheta
Supervision: De Peralta
and Narag

1/17/2019 OS - Enrile, Cagayan 6:00am 5:00pm

Investigation: Socorin
Supervision: Lappay

TOTAL
Prepared by :

I certify that : (1) I have reviewed the foregoing MARY GRACE M. DELA CRUZ
itinerary, (2) the travel is necessary to the Signature over Printed Name
service, (3) the period covered is reasonable and
(4) the expenses claimed are proper. Approved by:

BENITA L. MARAMAG
CPPO MARIA EMELIE C. CALAGUI Regional Director
Signature over Printed Name Signature over Printed Name
Immediate Supervisor Agency Head/Authorized Representative
 Appendix 45

ITINERARY OF TRAVEL

Entity Name : PAROLE AND PROBATION ADMINISTRATION

Fund Cluster: 01 No.: _______________

Name : MARIA EMELIE C. CALAGUI Date of Travel : October 1 - 3, 2017

Position : CPPO Purpose of Travel : Validation of the PWT Materials
Official Station : TCPPO
Places to be visited TIME Means of Per
Date Transpor- Others Total
(Destination) Departure Arrival Transportation tation Diem Amount

9/30 Official Station - terminal 6:45pm 7:00pm Tricy 50.00 50.00

Tuguegarao City - Sampaloc 7:15pm 9:00am bus 890.00 240.00 1,130.00
10/1 Bus Terminal - C. Office 9:05am 9:55am taxi 150.00 800.00 950.00

10/2 C.O Validation of PWT 640.00 640.00

C. Office - Terminal 5:50pm 6:20pm taxi 150.00 150.00
Bus Terminal - Tuguegarao City 6:30pm 7:30am bus 895.00 895.00

10/3 Terminal - Official Station 7:45 8:15 tricy 50.00 50.00

TOTAL 3,865.00
Prepared by :

I certify that : (1) I have reviewed the foregoing JAY L. CALIMAG

itinerary, (2) the travel is necessary to the Signature over Printed Name
service, (3) the period covered is reasonable and
(4) the expenses claimed are proper. Approved by:

BENITA L. MARAMAG
CPPO MARIA EMELIE C. CALAGUI Regional Director
Signature over Printed Name Signature over Printed Name
Immediate Supervisor Agency Head/Authorized Representative
 Appendix 47
CERTIFICATE OF TRAVEL COMPLETED

Entity Name: PAROLE AND PROBATION ADMINISTRATION Fund Cluster: 01

REGION 2

BENITA L. MARAMAG TCPPO

Regional Director Station

I HEREBY CERTIFY THAT I have completed the travel as authorized in the Travel
Order/Itinerary of Travel No.. ________ dated ________ under conditions indicated below:

/ x / Strictly in accordance with the approved itinerary.

/ / Cut short as explained below. Excess payment in the amount of
P_______ was refunded under O. R. No. ________ dated __________
/ / Extended as explained below, additional itinerary was submitted
/ / Other deviation as explained below.

Explanation or justifications:

Evidence of travel:

Office Order and Ceritificate of Appearance

Respectfully submitted:

MARY GRACE M. DELA CRUZ

Name of Employee

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

Approved:

BENITA L. MARAMAG
Regional Director
 LIQUIDATION REPORT
Period Covered ________________

Entity Name : PAROLE AND PROBATION ADMINISTRATION REGION 2

Fund Cluster : 01

PARTICULARS

To liquidate re: cash advance for TEV during attendance to the

validation of PWT Materials last October 2, 2017 at
PPA-Central Office per Special Order No. 458 S. 2017.

TOTAL AMOUNT SPENT

AMOUNT OF CASH ADVANCE PER DV NO.______DTD. ______
AMOUNT REFUNDED PER OR NO. ________DTD. ___________
AMOUNT TO BE REIMBURSED
A Certified: Correctness of the B Certified: Purpose of travel / C
above data cash advance duly accomplished

MARIA EMELIE C. CALAGUI

Signature over Printed Name Signature over Printed Name
Claimant Immediate Supervisor

Date: ______________________ Date: _____________________

 Appendix 44

Serial No.: _________________

Date: _____________________

Responsibility Center Code:

__________________________

AMOUNT

3,865.00
2,720.00

1,145.00
C Certified: Supporting documents
complete and proper

________________________
Signature over Printed Name
Head, Accounting Division Unit

JEV No.: ___________________

Date: _____________________
 Appendix 60

PURCHASE REQUEST

Entity Name: PAROLE AND PROBATION ADMINISTRATION REGION 2 Fund Cluster: 01

Office/Section : _____________ PR No.: ______________ Date: ____________

_________________________ Responsibility Center Code : ___________

Stock/ Property
Unit Item Description Quantity Unit Cost Total Cost
No.

Purpose: ____________________________________________________________
_______________________________________________________________
_______________________________________________________________

Requested by: Approved by:

Signature : _________________________ ___________________________
Printed Name : _________________________ ___________________________
Designation : _________________________ ___________________________

151
 Appendix 61

PURCHASE ORDER
PAROLE AND PROBATION ADMINISTRATION REGION 2
Entity Name

Supplier : _____________________________________________ P.O. No. : ____________________________

Address : _____________________________________________ Date : _______________________________
TIN : ________________________________________________ Mode of Procurement : _________________
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/
Unit Description Quantity Unit Cost Amount
Property No.

(Total Amount in Words)

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,

__________________________ ________________________________
Signature over Printed Name of Supplier
Signature over Printed Name of Authorized Official

___________________________ _____________________________
Date Designation

Fund Cluster : ___________________________________ ORS/BURS No. : ______________________

Funds Available : _________________________________ Date of the ORS/BURS: _______________
Amount : ____________________________
________________________________________
Signature over Printed Name of Chief Accountant/Head of
Accounting Division/Unit

153
153
 Appendix 62

INSPECTION AND ACCEPTANCE REPORT

Entity Name : PAROLE AND PROBATION ADMINISTRATION REGION 2 Fund Cluster : 01

Supplier : ______________________________________________ IAR No. : _______________

PO No./Date : ___________________________________________ Date : _________________
Requisitioning Office/Dept. : _______________________________ Invoice No. : ____________
Responsibility Center Code : _______________________________ Date : _________________
Stock/
Description Unit Quantity
Property No.

INSPECTION ACCEPTANCE

Date Inspected : ________________________ Date Received : _____________________

Inspected, verified and found in order as to Complete

quantity and specifications
Partial (pls. specify quantity)
____________________________________________ ___________________________________
Inspection Officer/Inspection Committee Supply and/or Property Custodian
 Appendix 62

ANCE REPORT

Fund Cluster : 01

IAR No. : _______________

Quantity

ACCEPTANCE

Received : _____________________

Complete

Partial (pls. specify quantity)

___________________________________
Supply and/or Property Custodian
 Appendix 63

REQUISITION AND ISSUE SLIP

Entity Name : PAROLE AND PROBATION ADMINISTRATION REGION 2 Fund Cluster : 01

Division : _______________________________________________ Responsibility Center Code : ______________________

Office : ________________________________________________ RIS No. : _____________________________________
Requisition Stock Available? Issue
Stock No. Unit Description Quantity Yes No Quantity Remarks

Purpose:

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

Signature :
Printed Name :
Designation :
Date :
AO 6/15/02
 Appendix 46 Appendix 46

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT

Entity Name: PAROLE AND Fund Cluster : 01 Entity Name: PAROLE AND Fund Cluster : 01
PROBATION ADMINISTRATION PROBATION ADMINISTRATION
REGION 2 REGION 2
Date : _______________________ RER No. : ___________________ Date : _______________________ RER No. : ___________________

RECEIVED from ______________________________________ RECEIVED from ______________________________________

(Name) (Name)

_________________________________________________ the amount _________________________________________________ the amount

(Official Designation) (Official Designation)

of __________________________________________ (P__________) of __________________________________________ (P__________)

(In Words) (in Figures) (In Words) (in Figures)

in payment for _______________________________________________ in payment for _______________________________________________

(Payments for subsistence, services, (Payments for subsistence, services,

_________________________________________________________ _________________________________________________________
rental or transportation should show inclusive dates, rental or transportation should show inclusive dates,

_________________________________________________________ _________________________________________________________
purpose, distance, inclusive points of travel, etc.) purpose, distance, inclusive points of travel, etc.)
PAYEE PAYEE
Name/Signature __________________________________________ Name/Signature __________________________________________
Address ________________________________________________ Address ________________________________________________

WITNESS WITNESS
Name/Signature __________________________________________ Name/Signature __________________________________________
Address ________________________________________________ Address ________________________________________________

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