Obligation Request and Status

HLURB request form for obligation and status

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Office of the President

HOUSING AND LAND USE REGULATORY BOARD
Kalayaan Ave., Cor. Mayaman St., Diliman, Quezon City

No.
Date:
Fund:

OBLIGATION REQUEST AND STATUS
Payee



Office
Address
Responsibility
Center

Particulars

MFO/PAP

UACS Code /
Expenditure

Amount

A.

Certified:
B.
Charges to appropriation/allotment necessary, lawful and
under my direct supervision and supporting documents valid,
proper and legal.

Certified:
Allotment available and obligated for the purpose as
indicated above.

Signature

Signature

Printed Name

Printed Name

Position

Position

Date

Date

C.

STATUS OF OBLIGATION
Reference

Date

Particulars

Amount
ORS/JEV/RCI/RADAI No.

Obligation

Payment

Totals

- To be printed back to back -


-

Not Yet Due

Due and
Demandable


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