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 LIQUIDATION REPORT LR No.:
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_______________________________________________
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SK of Barangay, City/Municipality, ProvinceDate:
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PARTICULARSAMOUNT
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TOTAL AMOUNT SPENT
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AMOUNT OF CASH ADVANCE PER DV NO._____DTD._____
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AMOUNT REFUNDED PER O.R. NO.________DTD.__________
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AMOUNT TO BE REIMBURSED
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A. Certified: Correctness of the above dataB. Certified: Purpose of cash advance duly accomplishedC. Certified: Supporting documents are complete and proper
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_______________________________________________________________________________
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Signature over Printed NameSignature over Printed NameSignature over Printed Name
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Accountable SK OfficialSK ChairpersonSK Treasurer
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___________________________________________________
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DateDateDate
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