Annex A Certification of Expenses not Requiring Receipts.xlsx

	A	C	D	E	G	I	J	K
1	Annex A				Annex A
2	DEPARTMENT OF EDUCATION				DEPARTMENT OF EDUCATION
3	City Schools Division of Cabuyao				City Schools Division of Cabuyao
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5	CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS				CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
6	Pursuant to COA Circular No. 2017-001 dated June 19, 2017				Pursuant to COA Circular No. 2017-001 dated June 19, 2017
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8	Name of Employee		Employee		Name of Employee		Employee
9	Name of Employee		No.		Name of Employee		No.
10	Office				Office
11	Division				Division
12	Particulars			Amount	Particulars			Amount
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22	TOTAL			-	TOTAL			-
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24	Purpose				Purpose
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29	I hereby certify that the above expenses are incurred as they are necessary for the above cited				I hereby certify that the above expenses are incurred as they are necessary for the above cited
30	purpose, that above goods and services were acquired form parties not issuing receipts. And that I				purpose, that above goods and services were acquired form parties not issuing receipts. And that I
31	am fully aware that willful falsification of statements is punishable by law.				am fully aware that willful falsification of statements is punishable by law.
32		Certified Correct:		Noted by:		Certified Correct:		Noted by:
33	Signature				Signature
34	Printed Name				Printed Name
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36		Date		Date		Date		Date
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