Annex A-1

Barangay of
City/Municipality of
Province of

PUNONG BARANGAYS CERTIFICATION (PBC)

(FOR BARANGAY CHECK DISBURSEMENTS)

To: The Bank Manager

(Bank)
(Address)

Sir/Madam:

This is to certify that the hereunder listed checks, with detail

check were issued by Barangay___________________.

Account No. Check No. Date

SUBSCRIBED AND SWORN to before me, this ______ day of _______________, 20_
__________________ who exhibited to me his Community Tax Certificate No. _______________issued at ___
_______________.

Delivered by:

____________________________________
Barangay Treasurer/Representative
y of
pality of
e of

CERTIFICATION (PBC)
K DISBURSEMENTS)

at the hereunder listed checks, with details of payee, amount and date of

Payee Amount

Very truly yours,

_____________________

me, this ______ day of _______________, 20__, by____________________

Certificate No. _______________issued at _____________on

Received by:

____________________________________
Bank Representative
Annex A-2
Barangay of
City/Municipality of
Province of

TRANSMITTAL LETTER (TL)

To: The City/Municipal Accountant

City/Municipality of _________________

Sir/Madam:

We submit herewith the original copies of the disburseme

the (Month and Year) duly acknowledged by the payees together with the supporting documents
and copies of the corresponding checks and Punong Barangay's Certification (PBC).

DV Check
Payee Amount
Date No. Date No.

Please acknowledge receipt here

Noted by: Received by:

___________________________ _____________________
Punong Barangay

Copy Furnished:
COA SA/ATL
 Date _____________

of the disbursement vouchers

ocuments

PBC/s Issued
Date No.

Very truly yours,

___________________________
Barangay Treasurer
___________________________
Date

________________________