Type (Form No.
) Annex 41
Page 1 of 2
REPORTS OF COLLECTIONS AND DEPOSITS
PIGCAWAYAN
LGU
Fund: Date: 8/22/2017
NAME: CRISTINE T. GOMOBAR Report No. _____________________
A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F# 51 7990752 7990752 Php 1,000.00
A.F# 51 7990759 7990759 Php 5,000.00
TOTAL Php 6,000.00
Name of Accountable Officer Report No.
B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.
Annex 41
SEF Page 2 of 2
C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
Name of Beginning Balance Receipt Issued Ending Balance
Forms &Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos.
No. From To From To From To From To
AF51 1 7990752 7990752 1 7990752 7990752 0 SOLD SOLD
AF51 1 7990759 7990759 1 7990759 7990759 0 SOLD SOLD
D. SUMMARY OF COLLECTIONS AND REMITTANCES / DEPOSITS
List of Checks:
Check Number Drawee Bank Date Amount
Total
Beginning Balance P Php 6,000.00
Add: Collections
Cash Php 6,000.00
Check/s P
Total P Php 6,000.00
Less: Remittance/Deposit to Cashier/ Php 6,000.00
Treasurer/Depository Bank
Balance P Php -
5
CERTIFICATION: VERIFICATION AND ACKNOWLEDGMENT:
I hereby certify that the foregoing report of collections I hereby certify that the foregoing report of collections
and deposits, and accountability for accountable forms has been verified and acknowledge receipt of ______
is true and correct. Php 6,000.00
CRISTINE T. GOMOBAR 8/22/2017 JAIME B. AQUINDE 8/22/2017
Name and Signature Date ACTING MUNICIPAL TREASURER Date
Accountable Officer
Type (Form No.) Annex 41
Page 1 of 2
REPORTS OF COLLECTIONS AND DEPOSITS
PIGCAWAYAN
LGU
Fund: TRUST FUND Date:10/09/2014
NAME: EXCELINO F. BUENO,JR. Report No. _____________________
A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F. 51 6206701C 6206701C Php 15,000.00
note: solicitation for the Mutya ng
Pigcawayan,2014
TOTAL Php 15,000.00
Name of Accountable Officer Report No.
B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.
Annex 41
S.E.F. Page 2 of 2
C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
Name of Beginning Balance Receipt Issued Ending Balance
Forms & Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos.
No. From To From To From To From To
AF 56 50 0731401C 0731450C 4 0731401C 0731404C 46 0731405C 0731450C
D. SUMMARY OF COLLECTIONS AND REMITTANCES / DEPOSITS
List of Checks:
Check Number Drawee Bank Date Amount
Total
Beginning Balance P Php -
Add: Collections
Cash Php 6,439.32
Check/s P
Total P Php 6,439.32
Less: Remittance/Deposit to Cashier/ Php 6,439.32
Treasurer/Depository Bank
Balance P Php -
CERTIFICATION: VERIFICATION AND ACKNOWLEDGMENT:
I hereby certify that the foregoing report of collections I hereby certify that the foregoing report of collections
and deposits, and accountability for accountable forms has been verified and acknowledge receipt of ______
is true and correct. Php 6,439.32
EXCELINO F. BUENO, JR. 8/29/2014 ARNELINDA B. PALMA 8/29/2014
Name and Signature Date MUNICIPAL TREASURER Date
Accountable Officer
REPORTS OF COLLECTIONS AND DEPOSITS
PIGCAWAYAN
LGU
Fund: SEF Date:08/29/2014
NAME: EXCELINO F. BUENO,JR. Report No. _____________________
A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F. 56 0731401C 0731404C Php 6,439.32
TOTAL Php 6,439.32
Name of Accountable Officer Report No.
B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.
Annex 41
Page 2 of 2
C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
Name of Beginning Balance Receipt Issued Ending Balance
Forms & Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos.
No. From To From To From To From To
A.F. 56 35 0545766C 0545800C 1 0545766C 0545766C 34 0545767C 0545800C
D. SUMMARY OF COLLECTIONS AND REMITTANCES / DEPOSITS
List of Checks:
Check Number Drawee Bank Date Amount
Total
Beginning Balance P
Add: Collections
Cash PHP 11101.79
Check/s P 11,101.79
Total P 11,101.79
Less: Remittance/Deposit to Cashier/ 11,101.79
Treasurer/Depository Bank
Balance P Php -
CERTIFICATION: VERIFICATION AND ACKNOWLEDGMENT:
I hereby certify that the foregoing report of collections I hereby certify that the foregoing report of collections
and deposits, and accountability for accountable forms has been verified and acknowledge receipt of ______
is true and correct. 11,101.79
LAURO P. BALOFINOS JAIME B. AQUINDE
Name and Signature Date Asst. Municipal Treasurer Date
Accountable Officer In-Charge of Office
NOTE: 0R# 5062959 - Solicitation for 59th Foundation Anniversary of Pigcawayan
OR# 5062960 - Cash Advance Refund
Type (Form No.) Annex 41
Page 1 of 2
REPORTS OF COLLECTIONS AND DEPOSITS
PIGCAWAYAN
LGU
Fund: Date:10/18/2012
NAME: LAURO P. BALOFINOS Report No. _____________________
A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F. 51 5062958 5062958 Php 7,905.60
TOTAL Php 7,905.60
Name of Accountable Officer Report No.
B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.
babeslargonio
Annex 41
Page 2 of 2
C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
Name of Beginning Balance Receipt Issued Ending Balance
Forms & Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos.
No. From To From To From To From To
A.F. 51 1 4970799C 4970799C 1 4970799C 4970799C SOLD SOLD
D. SUMMARY OF COLLECTIONS AND REMITTANCES / DEPOSITS
List of Checks:
Check Number Drawee Bank Date Amount
Total
Beginning Balance P Php -
Add: Collections
Cash 304.05
Check/s P 304.05
Total P 304.05
Less: Remittance/Deposit to Cashier/ 304.05
Treasurer/Depository Bank
Balance P Php -
5
CERTIFICATION: VERIFICATION AND ACKNOWLEDGMENT:
I hereby certify that the foregoing report of collections I hereby certify that the foregoing report of collections
and deposits, and accountability for accountable forms has been verified and acknowledge receipt of ______
is true and correct. 304.05
LAURO P. BALOFINOS JAIME B. AQUINDE
Name and Signature Date Asst. Municipal Treasurer Date
Accountable Officer In-Charge of Office
babeslargonio
Type (Form No.) Annex 41
Page 1 of 2
REPORTS OF COLLECTIONS AND DEPOSITS
PIGCAWAYAN
LGU
Fund: Date:10/10/2012
NAME: LAURO P. BALOFINOS Report No. _____________________
A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F. 51 4970799C 4970799C Php 304.05
TOTAL Php 304.05
Name of Accountable Officer Report No.
B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.
babeslargonio
Annex 41
Page 2 of 2
C. ACCOUNTABILITY FOR ACCOUNTABLE FORMS
Name of Beginning Balance Receipt Issued Ending Balance
Forms & Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos. Qty. Inclusive Serial Nos.
No. From To From To From To From To
A.F. 51 1 5062956 5062956 1 5062956 5062956 SOLD SOLD
D. SUMMARY OF COLLECTIONS AND REMITTANCES / DEPOSITS
List of Checks:
Check Number Drawee Bank Date Amount
0085531* BDO 10/15/2012 6,100.00
Total
Beginning Balance P Php -
Add: Collections
Cash
Check/s 6,100.00 P 6,100.00
Total P 6,100.00
Less: Remittance/Deposit to Cashier/ 6,100.00
Treasurer/Depository Bank
Balance P Php -
5
CERTIFICATION: VERIFICATION AND ACKNOWLEDGMENT:
I hereby certify that the foregoing report of collections I hereby certify that the foregoing report of collections
and deposits, and accountability for accountable forms has been verified and acknowledge receipt of ______
is true and correct. 6,100.00
LAURO P. BALOFINOS JAIME B. AQUINDE
Name and Signature Date Asst. Municipal Treasurer Date
Accountable Officer In-Charge of Office
babeslargonio
Type (Form No.) Annex 41
Page 1 of 2
REPORTS OF COLLECTIONS AND DEPOSITS
PIGCAWAYAN
LGU
Fund: Date:10/16/2012
NAME: LAURO P. BALOFINOS Report No. _____________________
A. COLLECTIONS
1. For Collectors
Official Receipt/Serial No.
Type (Form No.) From To
A.F. 51 5062956 5062956 Php 6,100.00
TOTAL
Name of Accountable Officer Report No. Php 6,100.00
B. REMITTANCES/DEPOSITS
Accountable Officer/Bank Report No.
babeslargonio
