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Appendix 12
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NOTICE OF OBLIGATION REQUEST AND STATUS ADJUSTMENTSerial No. : _________
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_______________________________Date : _____________
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Entity NameFund Cluster : ______
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For: The Budget Officer:
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Budget Division/Unit
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Please adjust ORS No. ___________________dated ___________________
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due to the following changes:
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Responsibility Center to ___________________________
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Particulars to ___________________________
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MFO/PAP to ___________________________
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Account Code to ___________________________
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Amount to P ___________________________
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Please adjust RAOD for excess/under obligation per attached
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JEV No. ___________dated ____________.
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Prepared by:
 Approved by:
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_________________________________________________________
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Accounting Staff-in-ChargeChief Accountant/Head of Accounting
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Division/Unit
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Certified Correct:
 Verified by:
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_____________________________________________________________
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Head of Requesting Office/ Head of Budget Division/Unit/
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Authorized RepresentativeAuthorized Representative
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