Travel Claim - Appendix A, B Etc - Dotollo
Travel Claim - Appendix A, B Etc - Dotollo
Travel Claim - Appendix A, B Etc - Dotollo
Department of Education
Region VIII (Eastern Visayas)
Division of Leyte
INOPACAN DISTRICT
Inopacan, Leyte
###
Office Order
No.______ s. 2015
o : RAUL V. DOTOLLO
Teacher I
Hinabay Elementary School
Inopacan District
Inopacan, Leyte
3.
Travel expenses incurred shall be charged against
School MOOE Funds subject to usual accounting and
auditing rules and regulations.
APPROVED:
DALIA P. RENOMERON
Head Teacher I
Date:
NAME:
RAUL V. DOTOLLO
Position:
Teacher I
Official Station:
Residence:
Inopacan, Leyte
DATE
PLACES TO BE VISITED
January-16
26
30
Means of
TIME OF
Transportati
DEPARTURE ARRIVAL
on
EXPENSE
HabalHinabay ES - Poblacion,
Habal
2:00 PM 2:30 PM
Fare
Inopacan, Leyte
(Motorcycle
)
Inopacan, Leyte - 3Js
3:00 PM 3:25 PM V-Hire
Fare
Hotel Hilongos, Leyte
Hilongos, Leyte Poblacion, Inopacan,
2:30 PM 3:00 PM V-Hire
Fare
HabalLeyte
Poblacion, Inopacan Habal
3:20 PM 3:50 PM
Fare
Hinabay ES
(Motorcycle
)
TOTAL
DALIA P. RENOMERON
Head Teacher I
TOTAL
Php35.00
50.00
50.00
35.00
###
Leyte Division
Station
January 31, 2016
Date
I CERTIFY THAT I have completed the travel authorized in itinerary of travel no. _________________
dated
January 25, 2016
under conditions indicated below:
[ x ] Strictly in accordance with the approved itinerary
[
] Cut short as explained below. Excess payment in the amount of Php____________ was
refunded under O.R. No. _____________ dated ___________________
[
[
Explained or justifications:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
____________________________________________________________________________________________
Evidences of Travel:
[ x ] Used Tickets
[ x ] Certificate of appearance
[ x ] Others _______RER__________________________
Respectfully submitted:
RAUL V. DOTOLLO
Teacher I
On evidence and information of which I have knowledge, the travel was actually undertaken.
DALIA P. RENOMERON
Head Teacher I
______________
ndertaken.
DEPARTMENT OF EDUCATION
Region VIII (Eastern Visayas)
Division of Leyte
INOPACAN DISTRICT
DISBURSEMENT VOUCHER
Mode of
Payment
MDS Check
Commercial Check
Payee
RAUL V. DOTOLLO
Address:
ADA
No. 2016-01-001
Others
TIN/Employee No.:
OR\BUR No.
Responsibility Center
Office/Unit/Project:
Code
EXPLANATION
AMOUNT
Php170.00
LSU-CDC
Certified:
Cash available
Signature
Printed Name
Position
Signature
Date
C
Php170.00
Printed Name
Position
DALIA P. RENOMERON
Head Teacher I
Date
JEV No.
Received Paymen
Check/ADA No
Signature
Official Receipt/Other Documents
Date:
Date:
Bank Name
Printed Name
Date