New Format for Common Use Forms to be Used Starting January 1, 2016

January 18, 2016 BLGF MEMORANDUM TO : All BLGF Officials and Employees SUBJECT : New Format for Common Use Forms to be Used Starting January 1, 2016 In compliance with the Commission on Audit (COA) Circular No. 2015-007 dated October 22, 2015, prescribing the Government Accounting Manual for use of All National Government Agencies, new various formats of books of accounts, registries, records, forms and reports, and the instructions on their use (GAM Annex A, Vol. II), shall be adopted and implemented effective January 2016 by the Financial and Management Division of this Bureau. These include new formats for disbursement vouchers, itinerary of travel, certificate of travel completed and all other common-use forms. Common-use forms and instructions on how to use the said forms are made available and can be downloaded through BLGF website (www.blgf.gov.ph). All claims shall only be processed by the Accounting unit if forms with new formats prescribed by the Commission on Audit is used. For strict compliance. (SGD.) JOCELYN T. PENDON OIC-Executive Director ATTACHMENT Certificate of Travel Completed (CTC) Instructions A. The CTC is a form used by officers/employees concerned to confirm that he/she has completed the travel or otherwise, based on the approved itinerary. It is one of the supporting documents to liquidate cash advances for travel. It shall be prepared by fund cluster. B. This form shall be accomplished as follows: 1. Entity Name name of the agency/entity 2. Fund Cluster the fund cluster name/code in accordance with the UACS 3. Director in-Charge shall be signed by the Director in-Charge of the office CHTAIc 4. Station the station where the officer/employee is assigned 5. Justification reason why the travel is not in accordance with the approved itinerary 6. Evidence of travel documents used, such as plane tickets, boarding passes, certificate of appearance, etc. 7. Certification the certification on the report shall be signed by the official/employee who made the travel on the last sheet of the report after the totals 8. Name of Employee name and signature of the official/employee who made the travel 9. Approved signature of the approving officer C. It shall be prepared in two (2) copies and shall be distributed as follows: Original - COA Auditor, through the Accounting Division/Unit, together with the LR and other supporting documents Copy 2 - Official/Employee's File Certification of Travel Completed Disbursement Voucher (DV) Instructions A. The DV is a form used to pay an obligation to employees/individuals/agencies/creditors for goods purchased or services rendered. It shall be prepared by the Requesting Office/Unit. The Accounting Division/Unit shall stamp on the face of this form the date of receipt from the requesting unit. B. This form shall be accomplished as follows: 1. Entity Name name of the agency/entity 2. Fund Cluster the fund cluster name/code in accordance with UACS in which the disbursement should be charged 01 Regular Agency Fund 02 Foreign Assisted Projects Fund 03 Special Account-Locally Funded/Domestic Grants Fund 04 Special Account-Foreign Assisted/Foreign Grants Fund 05 Internally Generated Funds (Off-Budgetary Funds Retained Income Funds) 06 Business Related Funds 07 Trust Receipts/Inter-Agency Transferred Funds 3. Date date of preparation of the DV 4. DV No. number assigned to the DV by the Accounting Division/Unit. It shall be numbered as follows: 5. Mode of Payment put a check " " mark in the appropriate box of the mode of payment (MDS Check, Commercial Check, ADA, Others) 6. Payee name of the payee/creditor EATCcI 7. TIN/Employee No. Tax Identification Number (TIN) of the claimant/Identification Number assigned by the agency to the officer/employee 8. ORS/BURS No. the serial number of the ORS or BURS supporting the DV 9. Address address of the claimant 10. Particulars brief description of the disbursement 11. Responsibility Center (Office/Unit/Project and Code) the office/unit/project and code assigned to the cost center where the disbursement shall be charged 12. MFO/PAP MFO or PAP as shown in the GAARD/SARO/GARO For Bureau of Local Government Finance MFO: REGULATION OF LGU FINANCIAL MANAGEMENT 1 Local Government Finance Policy Formulation, Monitoring and Evaluation 2 Development of LGU treasury and assessment operating policies, guidelines, systems and procedures including the promulgation of rulings/opinions for the proper implementation thereof 3 Conduct of revenue and assessment performance evaluation 4 Management, evaluation and monitoring of special projects on local government finance 5 LGU training on policies, procedures and other competency requirements of local treasurers and assessors 13. Amount amount of claim 14. Certified (Box A) certification by the responsible officer having direct supervision and knowledge of the facts of the transaction 15. Accounting Entry (Box B) the respective accounting entry for the disbursement 16. Certified (Box C) certification by the Head of Accounting Unit or his/her authorized representative on the availability of cash, subject to ADA, on the completeness of the supporting documents and the propriety of the amount claimed The certifying officer shall affix his/her signature and indicate his/her name and position/designation, and the date of signing on the spaces provided 17. Approved for Payment (Box D) approval by the Head of the Agency or his/her Authorized Representative on the payment covered by the DV The approving officer shall affix his/her signature and indicate his/her name and position/designation, and the date of signing on the spaces provided 18. Receipt of Payment (Box E) acknowledgment by the claimant or his/her duly authorized representative for the receipt of the check/ADA/cash and the date of receipt. The claimant/payee shall affix his/her signature on the space provided and shall indicate the number and the date of the check, bank name and account number, and OR number and date other relevant documents issued to acknowledge the receipt of payment DHITCc 19. JEV No. and Date number and date of the JEV covering the DV C. The DVs shall be prepared in four (4) copies to be distributed as follows: Original - COA, through Accounting Division/Unit together with the supporting documents for submission to the Auditor for post audit Copy 2 - Cash Treasury/Unit Copy 3 - Accounting Division/Unit Copy 4 - Payee Disbursement Voucher Itinerary of Travel (IoT) Instructions A. This form shall be used by the official/employee of the agency/entity making the travel to show the detailed itinerary of travel before and after the travel and shall be attached to all claims for traveling expenses (cash advance for travel and actual expenses). This shall be prepared by fund cluster. B. It shall be accomplished as follows: 1. Entity Name name of the agency/entity 2. Fund Cluster the fund cluster name/code in accordance with the UACS 3. No. number assigned to the IoT by the Administrative/Travel Unit 4. Name name of the official/employee going on travel 5. Position position of the official/employee going on travel 6. Official Station the official station of the official/employee going on travel 7. Date of Travel schedule of travel 8. Purpose of Travel purpose of travel based on the approved travel order 9. Date schedule of activities to be performed during the travel 10. Places to be visited places where the activities are to be performed 11. Time time of departure from and arrival to places to be visited 12. Means of Transportation means of transportation to be used such as plane, taxi, etc. 13. Transportation amount of transportation expenses 14. Per Diem amount of allowable traveling expense for subsistence and lodging 15. Others amount of other allowable expenses to be incurred/incurred during the travel 16. Total Amount total of transportation expense, per diem and other expenses 17. Total vertical total of 'Total Amount' column C. The "Prepared by" portion of the IoT shall indicate the printed name of, and be signed by the official/employee going on travel. cEaSHC D. The IoT shall be certified by the Immediate Supervisor of the official/employee going on travel, as follows: "I certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered is reasonable and (4) the expenses claimed are proper. ___________________________ Signature over Printed Name Immediate Supervisor " E. The "Approved by" portion of the IoT shall indicate the printed name of, and be signed by the Head of Agency or his/her Authorized Representative. F. This form shall be prepared in two copies distributed as follows: Original - COA Auditor, through the Accounting Division/Unit, together with the supporting documents to be attached to the DV for cash advance of estimated traveling expenses or payment of actual traveling expenses Copy 2 - Officer/Employee concerned Itinerary of Travel Liquidation Report (LR) Instructions A. The LR shall be used to liquidate cash advances for travel and related expenses by the employees/officers concerned of the agency/entity. It shall be supported by the required supporting documents. This shall be prepared by fund cluster. B. It shall be accomplished as follows: 1. Period Covered the period covered by the report from the date of the grant of cash advance up to the date of liquidation 2. Entity Name name of the agency/entity 3. Fund Cluster the fund cluster name/code in accordance with the UACS 4. Serial No./Date number assigned to the LR by the Accounting Division/Unit and the date of the preparation of the report 5. Responsibility Center Code code assigned to each cost/responsibility center 6. Particulars brief description of expenses incurred or deviation from original itinerary of travel 7. Amount amount of expenses covered by the report 8. Total amount spent actual amount spent 9. Amount of Cash Advance per DV No. amount of cash advance as indicated in the DV on the grant of cash advance; the DV number and date should be specified 10. Amount Refunded per OR No. amount refunded representing excess of the cash advance received over actual expenses incurred; the OR number and date should be specified 11. Amount to be Reimbursed amount due to the payee/claimant representing the difference between cash advance received and actual expenses incurred 12. Box A Certified: Correctness of the above data name and signature of the employee/officer who was granted the cash advance and the date it was signed 13. Box B Certified: Purpose of travel/cash advance duly accomplished name and signature of immediate supervisor of the official/employee who incurred the expenses and the date it was signed 14. Box C Certified: Supporting documents complete and proper name and signature of the Head of the Accounting Division/Unit and the date it was signed; the number of the JEV used as basis in recording the liquidation in the GJ should be indicated C. The amount spent per LR shall be taken up in the JEV, the refund shall be recorded in the CRJ, and the amount to be reimbursed shall be covered by another DV. D. It shall be prepared in two copies and shall be distributed as follows: CTIEac Original - COA Auditor, through the Accounting Division/Unit, together with the supporting documents Copy 2 - Accounting Division/Unit, to be attached to the JEV Copy 3 - Officer/Employee's File Liquidation Report Petty Cash Voucher (PCV) Instructions A. The form shall be accomplished as follows: 1. Entity Name name of the agency/entity 2. Fund Cluster the fund cluster name/code in accordance with the UACS 3. No. number assigned to the PCV by the PCFC. It shall be numbered as follows: 3. n Date date of the preparation of PCV 4. Payee/Office and Address name/office/address of payee/employee requesting cash advance charged to the PCF 5. Responsibility Center Code the cost/responsibility center code of the requesting office I. To be filled out upon request 6. Particulars brief description of the nature of disbursement/expense 7. Amount amount of petty cash requested 8. Box A Requested by shall be signed by the Requestor 9. Box A Approved by shall be signed by the Immediate Supervisor of the Requestor 10. Box B Paid by shall be signed by the PCFC 11. Box B Cash Received by shall be signed by the recipient of cash II. To be filled out upon liquidation 12. Total Amount Granted the amount of cash received by the claimant 13. Total Amount Paid per OR/Invoice No. ___________ the total amount paid as shown in the OR/invoice presented 14. Amount Refunded/Reimbursed the difference between the total amount granted less amount spent 15. Box C the PCFC shall check the appropriate box for "Received Refund" or "Reimbursement Paid" and affix his/her signature 16. Box D the payee shall check the appropriate box for "Liquidation Submitted" and/or "Reimbursement Received by" and affix his/her signature B. Part I shall be filled out upon request of the petty cash advance and Part II shall be filled out upon liquidation. SaCIDT C. The PCV shall be prepared in two copies distributed as follows: Original - to be attached to the RPPCV together with the supporting documents Copy 2 - PCFC file Petty Cash Voucher Purchase Request (PR) Instructions A. The PR is a form used by the Supply and/or Property Custodian for purchasing goods/supplies/property if the item/s requested is/are not available on stock. It shall be prepared by fund cluster. B. This form shall be accomplished as follows: 1. Entity Name name of the agency/entity 2. Fund Cluster fund cluster name/code in accordance with UACS 3. Office/Section name of the requesting office/section 4. PR No./Date number assigned to the PR and date it was prepared. It shall be numbered as follows: 5. Responsibility Center Code the assigned code of the cost/responsibility center requesting the purchase of item/s 6. Stock/Property No. number assigned to the item being requested 7. Unit unit of measurement of goods/property requested ( i.e. , piece, roll, box, ream, etc.) 8. Item Description brief description of the supplies/goods/property being requested 9. Quantity quantity of supplies/goods/property requested to be purchased 10. Unit Cost estimated cost per unit of the supplies/goods/property being requested 11. Total Cost estimated total cost of the supplies/goods/property being requested (Quantity x Unit Cost) 12. Purpose a brief explanation of the purpose why the supplies/goods/property are being requested 13. Requested by signature, printed name and designation of the person requesting the purchase of the item/s 14. Approved by signature, printed name and designation of the person approving the purchase of the item/s cHECAS C. Based on the approved PR, the Supply and/or Property Division/Unit shall process the procurement of the item/s requisitioned. D. The PR shall be prepared in three copies distributed as follows: Original - Supply and/or Property Division/Unit for their appropriate action, later to be attached to the original DV for the payment of purchased item/s Copy 2 - Supply and/or Property Division/Unit File Copy 3 - Requisitioning Department/Office/Division File Purchase Request Reimbursement Expense Receipt (RER) Instructions A. The RER is used to support the expenses which cannot be conveniently issued official receipts/invoice. It shall be submitted to the Accounting Division/Unit together with the LR and other supporting documents. It shall be prepared by fund cluster. B. This form shall be accomplished as follows: 1. Entity Name the name of the agency/entity 2. Date the date of the receipt 3. Fund Cluster the fund cluster name/code based on the UACS in which the disbursement shall be charged 4. RER No. the number assigned to the RER 5. Name the name of the official/employee who travelled 6. Official Designation the official designation or position of the official/employee who travelled 7. In words the amount in words of the actual payment made by the official/employee who travelled 8. In figures the amount in figures of the actual payment made by the official/employee who travelled 9. Payments the payments for subsistence, services, rental or transportation which show inclusive dates, purpose, distance, inclusive points of travel, etc. 10. Payee the name, signature and the address of the payee 11. Witness the name, signature and the address of the witness to the actual payment made by the official/employee who travelled Reimbursement Expense Receipt Requisition and Issue Slip (RIS) Instructions A. The RIS shall be used by the Requisitioning Division/Office to request supplies/goods/equipment/property carried in stock and by the Supply and/or Property Division/Unit to issue the items requested. B. This form shall be accomplished as follows: AHDacC 1. Entity Name name of the agency/entity 2. Fund Cluster fund cluster name/code in accordance with the UACS 3. Division/Office name of the requisitioning division/office 4. Responsibility Center Code cost/responsibility center code of the requisitioning division/office 5. RIS No. RIS control number assigned by the designated personnel in the Supply and/or Property Division/Unit. It shall be numbered in the following manner: 6. Requisition-Stock No. stock number of the item being requisitioned as provided by the Supply and/or Property Division/Unit 7. Requisition-Unit unit of measurement of the stock being requisitioned such as piece, roll, box, ream, etc. 8. Requisition-Description description of the item being requisitioned 9. Requisition-Quantity number/quantity of the stock being requisitioned 10. Purpose brief explanation of purpose pertaining to the stock being requisitioned 11. Requested by and date signature, printed name and designation of the Head/Authorized Representative of the Requisitioning Division/Office, and date of request 12. Approved by and date signature, printed name and designation of the person authorized to approve the issue of the item/s, and date of approval after determining the reasonableness of the quantity and nature of item/s being requested and ensuring that the same does/do not exceed the planned usage for the period 13. Stock Available? Yes or No A Purchase Request shall be prepared by the Requisitioning Office/Unit for item/s not available on stock 14. Issue-Quantity number of item/s issued 15. Issue-Remarks additional information regarding the item/s issued 16. Issued by and date signature, printed name and designation of the Supply and/or Property Custodian who issued the item/s and date of issue 17. Received by and date signature, name and designation of the person who received the item/s and date of receipt C. All item/s requested shall be based on the Project Procurement Management Plan. D. This form shall be prepared in three copies distributed as follows: Original - Accounting Division/Unit (to be attached to the RSMI) Copy 2 - Requisitioning Division/Office's file Copy 3 - Supply and/or Property Division/Unit's file Requisition and Issue Slip n Note from the Publisher: Copied verbatim from the official copy.