0149 Atap SK Brgy. Kaulanguhan, Caibiran
0149 Atap SK Brgy. Kaulanguhan, Caibiran
0149 Atap SK Brgy. Kaulanguhan, Caibiran
To: The Manager ATAP NO. NL-22-0149[JM] 1 To: The Manager ATAP NO. NL-22-0149[JM]
LBP/DBP/PVB LBP/DBP/PVB
PRINT IN 4 COPIES – PRESENT THIS WITH THE DEPOSIT SLIPS AND GIVE 2 COPIES TO THE BANK
FOR DEPOSIT TO SAVINGS ACCOUNT OF THE TREASURER OF THE PHILIPPINES FOR DEPOSIT TO SAVINGS ACCOUNT OF THE TREASURER OF THE PHILIPPINES
PAYING AGENCY LGU-BILIRAN PROVINCE AREA CODE 0837 PAYING AGENCY LGU-BILIRAN PROVINCE AREA CODE 0837
PAYING AGENCY CODE Y0075 DATE PREPARED 06-Sep-22 PAYING AGENCY CODE Y0075 DATE PREPARED 06-Sep-22
ADDRESS SK BRGY. KAULANGUHAN, CAIBIRAN BILL NO. (YR-MONTH-NUMBER) ADDRESS SK BRGY. KAULANGUHAN, CAIBIRAN BILL NO. (YR-MONTH-NUMBER)
COMPUTATION OF FIDELITY BOND PREMIUM DUE COMPUTATION OF FIDELITY BOND PREMIUM DUE
VALID ONLY WITHIN THE MONTH OF ISSUANCE VALID ONLY WITHIN THE MONTH OF ISSUANCE
BIENVENIDO F. LACABA JR. MARIA FE LUZETTE D. LUMAPAS BIENVENIDO F. LACABA JR. MARIA FE LUZETTE D. LUMAPAS
TROO IV OIC-PROVINCIAL HEAD TROO IV OIC-PROVINCIAL HEAD
Signature Over Signature Over Signature Over Signature Over
Printed Name and Position Printed Name and Position Printed Name and Position Printed Name and Position
FOR BANK'S USE ONLY FOR BANK'S USE ONLY
DETAILS OF PAYMENT DETAILS OF PAYMENT
PARTICULARS DRAWEE BANK / NUMBER PARTICULARS DRAWEE BANK / NUMBER
CASH P CASH P
CHECK CHECK
TOTAL PAYMENT RECEIVED P TOTAL PAYMENT RECEIVED P
BANK MACHINE VALIDATION OF AMOUNT AND DATE BANK MACHINE VALIDATION OF AMOUNT AND DATE
*
*
3 4 0 2 2 85 1 5 9 BTr - Fidelity Bond Fund/ Bureau of the Treasury
110050300008 *
LM0417