Neftaly

Financial Reporting Form – September Disbursement

Date	Disbursement ID	Program/Project Name	Recipient / Vendor	Amount Disbursed (USD)	Payment Method	Purpose / Description	Authorized By	Notes
YYYY-MM-DD	DISB-0001	Community Outreach	ABC Supplies	2,500	Bank Transfer	Purchase of educational materials	John Doe	Invoice #1234 attached
YYYY-MM-DD	DISB-0002	Health Campaign	XYZ Health Services	3,750	Check	Health workshop facilitation	Jane Smith
YYYY-MM-DD	DISB-0003	Livelihood Support	Local Artisans Group	1,200	Cash	Seed funding for micro-business	Mark Johnson	Follow-up due in Oct

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Summary

• Total Disbursement Amount (September): $__________
• Number of Disbursements: __________

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Instructions:

• Record each disbursement with complete details.
• Attach supporting documents like invoices or receipts.
• Ensure all disbursements are authorized and compliant with Neftaly policies.
• Submit this form to the Finance Department by the 5th of the following month.