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PROVINCIAL SOCIAL WELFARE AND DEVELOPMENT PROVINCIAL SOCIAL WELFARE AND DEVELOPMENT

OFFICE OFFICE
CERTIFICATE OF EXPENSES NOT REQUIRING RECEIPTS CERTIFICATE OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017 Pursuant to COA Circular No. 2017-001 dated June 19, 2017
Name of Employee Employee No.
Name of Employee Employee No.

Office
Office PSWDO PSWDO
Division FAMILY Division FAMILY
Particulars Amount (₱) Particulars Amount (₱)

TOTAL TOTAL
Purpose Purpose

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above I hereby certify that the above expenses are incurred as they are necessary for the above cited above cited purpose, that
goods and services were acquired from parties not issuing receipts. And that I am fully aware that witful falsification of goods and services were acquired from parties not issuing receipts. And that I am fully aware that witful
statements is punishable by law. falsification of statements is punishable by law.

Certified correct: Noted by: Certified correct: Noted by:

Signature Signature

Printed Name Printed Name


Employee Immediate Supervisor Employee Immediate Supervisor

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