DESCRIPTION OF EXPENDITURE - ATTACH RECEIPTS AND OTHER SUPPORTING DOCUMENTS
I CERTIFY THAT THIS VOUCHER AND ANY ATTACHMENTS ARE CORRECT. THE EXPENDITURES WERE INCURRED ON OFFICIAL BUSINESS OF A CONFIDENTIAL. EXTRAORDINARY. OR EMERGENCY NATURE. PAYMENT OR CREDIT HAS NOT BEEN RECEIVED, AND I SHALL NOT BE REIMBURSED FROM ANY OTHER SOURCE. DATE SIGNATURE OF PAYEE
(A) PAYMENT RECEIVED
IN THE AMOUNT OF $
I CERTIFY FUNDS ARE AVAILABLE DATE
OBLIGATION REFERENCE NO. CHARGE ALLOTMENT NO. APPROVED DATE SIGNATURE OF PAYEE
(A)
SIGNATURE OF APPROVING OFFICER
DATE SIGNATURE OF AUTHORIZING OFFICER
(A) CERTIFIED FOR PAYMENT OR CREDIT DATE SIGNATURE OF RECIPIENT
DATE SIGNATURE OF CERTIFYING OFFICER
SPACE BELOW FOR EXCLUSIVE USE OF FINANCE DIVISION
PREPARED BY REVIEWED BY VOUCHER NO. 7-12
13-39 DESCRIPTION - ALL OTHER ACCOUNTS 40-42 EXPEND CODE 45-49 PAY PER. LIO. CODE 47-52 OBLIG REF. NO. ADVANCE ACCT. NO.EMP. NO. 53 YR 54-57 GENERAL LEDGER ACCT. NO. 59-67 ALLOT. LEDGER ACCT. NO. 68-70 DUE DATE. 71-80 AMOUNT
DESCRIPTION - A/P ITEMS 13-33 34-39 PAYABLE VOU. NO. DEBIT CREDIT
DESCRIPTION - ADVANCE ACCOUNTS 13-24