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Itinerary of Travel: Appendix A

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Appendix A

Republic of the Philippines


Province of Negros Oriental
Municipality of La Libertad

ITINERARY OF TRAVEL

Entity Name : _____________________


Fund Cluster: ____________________ No.: _______________
Name : ____________________________________________ Date of Travel : _____________________________
Position : __________________________________________ Purpose of Travel : __________________________
Official Station : _____________________________________ ___________________________________________
Places to be visited TIME Means of Transpor Per Total
Date Others
(Destination) Departure Arrival Transportation -station Diem Amount

TOTAL
Prepared by :

I certify that : (1) I have reviewed the foregoing _____________________________________________


itinerary, (2) the travel is necessary to the Signature over Printed Name
service, (3) the period covered is reasonable and
(4) the expenses claimed are proper. Approved by:

____________________________________ ______________________________________________
Signature over Printed Name Signature over Printed Name
Immediate Supervisor Agency Head/Authorized Representative

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