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Appendix 43
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CASH DISBURSEMENTS REGISTER
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Entity name: _______________________________________________
Name of Accountable Officer: ____________________
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Sub-Office/District/Division : _________________________________
Official Designation: ___________________________
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Municipality/City/Province: __________________________________
Station: _______________________________________
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Fund Cluster: ___________
Register No.
__________________________________
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Sheet No.
__________________________________
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DateDV/Payroll/
Check No./
OR No.
ParticularsAdvances for Operating Expenses (19901010)BREAKDOWN OF PAYMENTS
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AmountElectricityInternetOther General ServicesO T H E R S
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Cash AdvancePayments Balance Account DescriptionUACS Object CodeAmount
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(5020402000)(5020503000)(5021299099)
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Balance from previous month
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CASH ADVANCE
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- - - - - - -
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Account DescriptionUACS Object CodeAmount
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Total -
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The total of the "Advances for Operating Expenses - Payments' column must alwaysmbe equal to the sum of the totals of the 'Breakdown of Payments' columns.
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CERTIFIED CORRECT: RECEIVED BY:
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_______________________________________________________
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Principal
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Date: Date:
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