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Appendix 14
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BUDGET UTILIZATION REQUEST AND STATUSSerial No. : 2-207507-2025-
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 BUREAU OF SOILS AND WATER MANAGEMENTDate : _________________________REMINDERS:
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Entity NameFund Cluster : 01Print four (4) copies of BURS
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PayeeNAMEGreen font - fill out correct details
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Red font - fill out correct amount
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OfficeBSWMIf details are final, make it black font.
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UACS Object Code will be filled-out by Budget Section
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AddressSRDC, Quezon City**make sure that the status of appointment indicated in the travel order is correct (Permanent or Contract of Service)
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Before releasing to Budget Section, countersignature of Ms. Narcisa D. Ramis of Accounting Section is needed.
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Responsibility CenterParticularsMFO/PAPUACS Object Code/ ExpendituresAmount
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 To download this form, click "File", "Download", and "Microsoft Excel"
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To reimburse actual travelling expenses and allowable per diem as per attached supporting documents in the total amount of .................N/A 10,000.00
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T.O. #:
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Date:
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Destination:
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 Total 10,000.00
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A.B.
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Certified: Charges to appropriation/budget are
Certified: Budget available and utilized
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necessary, lawful and under my direct supervision; and
for the purpose/adjustment necessary as
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supporting documents valid, proper and legal
indicated above
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Signature : ___________________________________Signature : ___________________________________
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Printed Name : GINA P. NILO, Ph.D.Printed Name : SARAH B. SUMINISTRADO
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Position : DirectorPosition : Head, Budget Section
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Date : ___________________________________Date : ___________________________________
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C.STATUS OF UTILIZATION
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ReferenceAmount
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DateParticularsBURS/JEV/RCI/ RADAI/RTRAI No.UtilizationPayablePaymentBalance
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Not Yet DueDue and Demandable
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(a)(b)(c)(a-b)(b-c)
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Utilization 10,000.00
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