Annex 15



A. This report shall be accomplished as follows:

1. Barangay, City/Municipal, Province - name of the barangay and city/municipal and province of the barangay
2. LR No. - assigned number of the liquidation report. The LR shall be numbered as follows:

3. Date - date of report
4. Particulars - brief description of the cash advance being liquidated and the details of the expenses covered by the report
5. Amount - the corresponding amount of expenses/payments made out of the cash advance
6. Total Amount Spent - total payments/amount spent
7. Amount of Cash Advance - amount of cash received (indicate the date and the number of the check/DV)
8. Amount Refunded - is the excess amount of the cash advance (amount of cash advance less the total amount spent). Indicate the OR No. and date of the refund.
9. Amount to be Reimbursed - is the excess of the total amount spent over the cash advance received. A new DV shall be prepared for the reimbursement.
10. Submitted by - to be signed by the accountable officer submitting the LR and the date of submission
11. Received by - to be signed by Accounting Unit acknowledging the receipt of the LR.
12. Accounting Entries - to be prepared by the Barangay Bookkeeper and approved by the C/M Accountant. The date of preparation and approval shall be indicated.

B. It shall be prepared in three copies to be distributed as follows:

Original Copy - COA auditor concerned, thru the C/M Accountant
2nd copy - C/M Accountant's file
3rd copy - Accountable Officer's file

C. Supporting documents shall be attached like invoices, ORs, and other pertinent documents.

D. In case of cash advance for travel, supporting documents shall include plane/bus/boat tickets or equivalent, boarding pass, certificate of appearance.

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