CHECK DISBURSEMENTS REGI

For the Month of ______________

Barangay: _____________ City/Municipality: _____

Barangay Treasurer: ___________ Province: ___________
Current Account No.: ___________
BREAKDOWN OF PAYMENTS

Maintenance and Other Operating Expenses

Date
Particulars Ref.
2007 Honorarium

Certification:
I hereby certify to the correctness of the above data. Records are
and that the carbon copies of the checks issued and all the original of the p
are in my file.
ENTS REGISTER
____________

Municipality: ______________ CkDReg No.: __________

nce: ___________________ Page: _____________

PAYMENTS
Capital OTHERS (See List at the Deductions
Outlay Back) Amount
Gross
of Checks
Amount
Issued
Account Due to
Amount
Classification BIR Others

above data. Records are based on the SCkI submitted by the BT

and all the original of the paid DVs/payroll supporting the entries,
 CASH RECEIPTS AND DEPOSITS REGISTER
For the Month of _____________

Barangay: __________________ City/Municipality: _________________ CRReg No.: __________

Barangay Treasurer: _______________ Province: ___________________ Page: 1 of 1 __________

Distribution of Receipts
Date Remittance Undeposited/
Receipts Deposits Business Clearance Business OTHERS (See List at the Back)
Particulars Ref. C/MT Unremitted Misc.
Collection IRA RPT Taxes and & Cert. Permit
Income Account
2007 Licenses Fees Fee Amount
Classification

Certification:

I hereby certify to the correctness of the above data. Recordings are based on the certified SCDs supported
with duplicate ORs and VDS submitted by the BT, CMs, and bank statements which are all in my file.

Barangay Record Keeper Date

 Summary of Collections and Deposits
For the Period _____________

Barangay: _______________ City/Municipality:

Barangay Treasurer: ________________ Province: __________________
Date
OR/VDS/SCR No. Payor/Bank Particulars Barangay
2007 Collections
Beginning Balance

January

February

March

April

May

June

July

August

September

October

November

December

Certification: Acknowledgment:
I hereby certify that the foregoing is the complete and correct I hereby acknowledge to ha
records of all my collections and deposits from Jan. 2 to Jan 6, complete with the duplicate copi
2007. The duplicate copies of the ORs issued, SCRs and the SCRs and the VDS covering deposi
originals of the VDS are hereto attached.

Barangay Treasurer
 and Deposits
________

SCD No.:
Page: __________

Barangay As deputized by City/Municipality

Deposit Balance Collection Remittance Balance

cknowledgment:
I hereby acknowledge to have received the SCD
mplete with the duplicate copies of the ORs issued,
CRs and the VDS covering deposits as reported.

Barangay Record Keeper

 Summary of Checks Issued
For the Period ______________

Barangay: _______________
Barangay Treasurer: __________________

Date Check
DV No Fund Payee Particulars
2007 No.

Certification:
I hereby certify that the foregoing is the complete and correct records
of all checks issued from Jan. 2 to Jan. 6, 2007. The carbon copies
of the checks issued and originals of all paid DVs/payrolls are hereto attached.

____________________ _________
Barangay Treasurer Date
f Checks Issued
d ______________

City/Municipality: _______________ SCkI No.: ________________

Province: ________________ Page: ________________

Gross Deductions Net

s
Amount Amount

Acknowledgment:
I hereby acknowledge receipt of the SCkI complete with carbon
copies of all the checks issued and originals of all paid DVs/payrolls
and its supporting documents.

________________________ ________
Barangay Record Keeper Date
 Summary of Cash Payment
For the Period _______________

Barangay: ____________ City/Municipality: ___________

Barangay Treasurer: ___________ Province: ______________
Date Payroll/
Payee Particulars
2007 DV No.

Certification: Acknowledgment:
I hereby certify that the foregoing is th I hereby acknowledge the receipt of the c
and correct records of all cash payments fo complete with the originals of the paid DVs/
period Jan. 15 to Jan.18, 2006. The origina and supporting documents.
DVs/payrolls are hereto attached.

___________________ ______________________
Barangay Treasurer Barangay Record Keeper
yment
_______

SCP No.: ________

Withholding Net Amount

Gross Amountl
Tax Paid

owledge the receipt of the certified SCP

e originals of the paid DVs/payroll
documents.

________________________
Barangay Record Keeper
 CASH DISBURSEMENTS REGISTER

For the Month of _______________

Barangay: __________________ City/Municipality: ______________ CDReg No. _____________

Barangay Treasurer: ___________ Province: __________________ Page No. _____________
Payroll Fund Breakdown of Payments Deductions

Date Particular Reference Salaries and

Withholding
Cash Advance Disbursements Balance Wages - Honoraria
Tax
Regular

Certification :
I hereby certify to the correctness of the above data. Records are based
on the SCP submitted by the AO and that all the originals of the paid DVs/
payroll are all in my file.

__________________________ ___________
Barangay Record Keeper Date