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1 No exception noted.

2 No data indicated.
3 Error in computation
4 Does not tally/reconcile with the supporting schedule
5 Data erroneously filled-up on the wrong field.
6 No supporting schedule attached.
7 No signature affixed.

Cash Examination Report Fields


SECTION A
Accountable Officer Position/Designation Fund A - 1 A - 2 A - 3 A - 4 A - 5 A - 6 A - 7 A - 8 A - 9 A - 10 A - 11
. Liezl C. Peñamora Cashier C Cash - CO 1 1 1 1 1 1 1 1 1 1 1
Cash in Bank
. Tirso R. Rivera Customer Service Asst. B
. Marna P. Garcia Clerk Processor B
. Mortiz Arnel Potestades Utility Service Asst. D
. Javier Herson Torres Utility Service Asst. D
. Guillermo A. Auditor, Jr. Utility Service Asst. D
. Jerry D. Cuento Utility Service Asst. D

Legend:
Section A
A - 1 Name of Accountable Officer
A - 2 Position
A - 3 Agency
A - 4 Station
A - 5 Maximum Cash Accountability
A - 6 Amount of Bond
A - 7 Risk No.
A - 8 Effective Date
A - 9 Auditor/Examiner
A - 10 Official Designation
A - 11 Accountable Officer
A - 12 Position
A - 13 Date
A - 14 Noted and Complied With - Accountable Officer Signature
A - 15 Date
A - 16 Auditor/ Duly Authorized Representative's Signature

1 No exception noted.
2 No data indicated.
3 Error in computation
4 Does not tally/reconcile with the supporting schedule
5 Data erroneously filled-up on the wrong field.
6 No supporting schedule attached.
7 No signature affixed.
Does not tally/reconcile with the supporting schedule

Cash Examination Report Fields


SECTION A SECTION B
Accountable Officer Position/Designation Fund A - 12 A - 13 A - 14 A - 15 A - 16 B -1 B -2 B -3 B -4 B -5
Liezl C. Peñamora Cashier C Cash - CO 1 1 1 1 1 1 1 1 1 2
Cash in Bank
Tirso R. Rivera Customer Service Asst. B
Marna P. Garcia Clerk Processor B
Mortiz Arnel Potestades Utility Service Asst. D
Javier Herson Torres Utility Service Asst. D
Guillermo A. Auditor, Jr. Utility Service Asst. D
Jerry D. Cuento Utility Service Asst. D

Section B
B -1 Inventory of Cash on Hand
B -2 Total, As Presented
B -3 Inventory of Cash Items
B -4 Total, As Presented
B -5 Total Inventory of Cash
and/or Cash Items (To D)
1 No exception noted.
2 No data indicated.
3 Error in computation
4 Does not tally/reconcile with the supporting schedule
5 Data erroneously filled-up on the wrong field.
6 No supporting schedule attached.
7 No signature affixed.

Cash Examination Report Fields


SECTION C
Accountable Officer Position/Designation Fund C -1 C -1.1 C -1.2 C -1.3 C -1.4 C -1.5 C -2 C -2.1 C -2.2 C -2.3
Liezl C. Peñamora Cashier C Cash - CO 5 5 5 5 5 5 2 2 2 2
Cash in Bank
Tirso R. Rivera Customer Service Asst. B
Marna P. Garcia Clerk Processor B
Mortiz Arnel Potestades Utility Service Asst. D
Javier Herson Torres Utility Service Asst. D
Guillermo A. Auditor, Jr. Utility Service Asst. D
Jerry D. Cuento Utility Service Asst. D

Section C - Inventory of Unused Accountable Forms


C -1 With Money Value
C -1.1 Name of Forms
C -1.2 Qty.
C -1.3 Serial No.
C -1.4 Denomination
C -1.5 Amount
C -2 Without Money Value
C -2.1 Name of Forms
C -2.2 Qty.
C -2.3 Serial No.
C -3 Total
C -4 Certification of the Auditor/Examiner
C -4.1 Cash and/or cash items
C -4.2 Unused accountable forms with money value
C -4.3 Unused accountable forms without money value
C -5 Accountable Officer's Signature
C -6 Position
C -7 Agency/Station
C - 8 Signed in the Presence of Witness 1
C - 8.1 Witness 2

1 No exception noted.
2 No data indicated.
3 Error in computation
4 Does not tally/reconcile with the supporting schedule
5 Data erroneously filled-up on the wrong field.
6 No supporting schedule attached.
7 No signature affixed.
Does not tally/reconcile with the supporting schedule
Data erroneously filled-up on the wrong field.

Cash Examination Report Fields


SECTION C
Accountable Officer Position/Designation Fund C -3 C -4 C -4.1 C -4.2 C -4.3 C -5 C -6 C -7 C -8 C -8.1
Liezl C. Peñamora Cashier C Cash - CO 2 1 1 1 2 1 1 1 1 1
Cash in Bank
Tirso R. Rivera Customer Service Asst. B
Marna P. Garcia Clerk Processor B
Mortiz Arnel Potestades Utility Service Asst. D
Javier Herson Torres Utility Service Asst. D
Guillermo A. Auditor, Jr. Utility Service Asst. D
Jerry D. Cuento Utility Service Asst. D
1 No exception noted.
2 Error/No data indicated.
3 Error in computation
4 Does not tally/reconcile with the supporting schedule
5 Data erroneously filled-up on the wrong field.
6 No supporting schedule attached.
7 No signature affixed.
8 Error in extension of totals

Cash Examination Repo


SECTION D
Accountable Officer Position/Designation Fund D -1 D -2 D -3 D -4 D -5 D -6 D -7 D -8 D -9 D -10 D -11
Liezl C. Peñamora Cashier C Cash - CO 1 4 1 1 1 1 1 1 1 7 1
Cash in Bank
Tirso R. Rivera Customer Service Asst. B
Marna P. Garcia Clerk Processor B
Mortiz Arnel Potestades Utility Service Asst. D
Javier Herson Torres Utility Service Asst. D
Guillermo A. Auditor, Jr. Utility Service Asst. D
Jerry D. Cuento Utility Service Asst. D

Section D. Statement of Accountabilty


D -1 Nature of Funds
D -2 Balance , Last Examination (Date)
D -3 Debits to Accountability
D -4 Total Debits to Accountability
D -5 Credits to Accountability
D -6 Total Credits to Accountability
D -7 Balance of Accountability as of _________.
D -8 Inventory of Cash and/or Allowed Cash Items
D -9 Shortage or (Overage)
D -10 Totals
D -11 Certification by the Accountable Officer
D -12 Accountable Officer's Signature
D -13 Position/Designation
D -14 Agency/Station
D -15 Name of Accountable Officer
D -16 Position/Designation
D -17 Agency/Station
D -18 Date
D -19 Remarks
D -20 Signature of Auditor's/Examiners 1
D -20.1 2
D -20.2 3
D -21 Date
Does not tally/reconcile with the supporting schedule
Data erroneously filled-up on the wrong field.

Cash Examination Report Fields


SECTION D
Accountable Officer Position/Designation Fund D -12 D -13 D -14 D -15 D -16 D -17 D -18 D -19 D-20 D-20.1 D -20.2
Liezl C. Peñamora Cashier C Cash - CO 1 1 1 1 1 1 7 1 7
Cash in Bank
Tirso R. Rivera Customer Service Asst. B
Marna P. Garcia Clerk Processor B
Mortiz Arnel Potestades Utility Service Asst. D
Javier Herson Torres Utility Service Asst. D
Guillermo A. Auditor, Jr. Utility Service Asst. D
Jerry D. Cuento Utility Service Asst. D
Report Fields

Accountable Officer Position/Designation Fund D -21


Liezl C. Peñamora Cashier C Cash - CO
Cash in Bank
Tirso R. Rivera Customer Service Asst. B
Marna P. Garcia Clerk Processor B
Mortiz Arnel Potestades Utility Service Asst. D
Javier Herson Torres Utility Service Asst. D
Guillermo A. Auditor, Jr. Utility Service Asst. D
Jerry D. Cuento Utility Service Asst. D
Legend: 1 No exception noted.
Section A 2 No data indicated.
A-1 Name of Accountable Officer 3 Error in computation
A-2 Position 4 Does not tally/reconcile with the supp
A-3 Agency 5 Data erroneously filled-up on the wro
A-4 Station 6 No supporting schedule attached.
A-5 Maximum Cash Accountability
A-6 Amount of Bond
A-7 Risk No.
A-8 Effective Date
A-9 Auditor/Examiner
A - 10 Official Designation
A - 11 Accountable Officer
A - 12 Position
A - 13 Date
Noted and Complied With - Accountable Officer
A - 14 Signature
A - 15 Date
Auditor/ Duly Authorized Representative's
A - 16 Signature

Section B
B -1 Inventory of Cash on Hand
B -2 Total, As Presented
B -3 Inventory of Cash Items
B -4 Total, As Presented
Total Inventory of Cash and/or Cash Items (TO
B -5 D)

Section C - Inventory of Unused


Accountable Forms
C -1 With Money Value
C -1.1 Name of Forms
C -1.2 Qty.
C -1.3 Serial No.
C -1.4 Denomination
C -1.5 Amount

C -2 Without Money Value


C -2.1 Name of Forms
C -2.2 Qty.
C -2.3 Serial No.
C -3 Total
C -4 Certification of the Auditor/Examiner
C -4.1 Cash and/or cash items
C -4.2 Unused accountable forms with money value
C -4.3 Unused accountable forms without money value
C -5 Accountable Officer's Signature
C -6 Position
C -7 Agency/Station
C-8 Signed in the Presence of
C - 8.1 Witness 1
C - 8.2 Witness 2

Section D. Statement of Accountabilty


D -1 Nature of Funds
D -2 Debits to Accountability
D -3 Total Debits to Accountability
D -4 Credits to Accountability
D -5 Total Credits to Accountability
D -6 Balance of Accountability as of Mar. 9, 2016
D -7 Inventory of Cash and/or Allowed Cash Items
D -8 Shortage or (Overage)
D -9 Certification by the Accountable Officer
D -10 Accountable Officer's Signature
D -11 Position/Designation
D -12 Agency/Station
D -13 Name of Accountable Officer
D -14 Position/Designation
D -15 Agency/Station
D -16 Date
D -17 Remarks
D -18 Signature of Auditor's/Examiners
D -18.1 1
D -18.2 2
D -18.3 3
D -19 Date
ption noted.

computation
t tally/reconcile with the supporting schedule
oneously filled-up on the wrong field.
orting schedule attached.
with money value
without money value