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Appendix 34 CkADADRec

This document is a record template for checks and advices to debit account disbursements. It includes sections for entity details, accountable officer information, and certification of the accuracy of the records. The template is designed to track financial transactions over a specified period.

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Rosette Diane Palacpac
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11 views1 page

Appendix 34 CkADADRec

This document is a record template for checks and advices to debit account disbursements. It includes sections for entity details, accountable officer information, and certification of the accuracy of the records. The template is designed to track financial transactions over a specified period.

Uploaded by

Rosette Diane Palacpac
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd

Appendix 34

CHECKS AND ADVICES TO DEBIT ACCOUNT DISBURSEMENTS RECORD

Entity Name : _________________________________________ Fund Cluster :_________________


Bank Name/Bank Account Number : _____________________ Sheet No. : ____________________

________________________________________________ ___________________________ _______________________


Accountable Officer Official Designation Station
NCA/DS/DV/Payroll Check/ADA Amount
Nature
Serial No. UACS Object NCA
Payee of
Date Code Received/ Check ADA NCA/Bank
No. Date Date
Released
Payment
Deposit Issued Issued Balance
Check ADA Made

CERTIFICATION

I hereby certify on my official oath that the foregoing is a correct and complete record of all checks/ADAs issued by me in my capacity as _________________________ of
_____________________________________
(Designation) (Name of Agency)
during the period from _______________ to _______________, inclusive, as indicated in the corresponding columns.

___________________________
Name and Signature
________________
Date

96

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