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Appendix 15
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NOTICE OF BUDGET UTILIZATION REQUEST AND STATUS ADJUSTMENTNBURSA No. : __________
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Date : _________________
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_______________________________Fund Cluster : __________
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Entity Name
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For: The Budget Officer:
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Budget Division/Unit
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Please adjust BURS 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 RBUD 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
Division/Unit
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Certified Correct:
 Verified by:
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__________________________________________________________________
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Head of the Requesting Office/Authorized RepresentativeHead of the Budget Division/Unit/Authorized Representative
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