Appendix 45
ITINERARY OF TRAVEL
Entity Name : QUEZON CENTRAL ELEMENTARY SCHOOL
Fund Cluster: _MOOE No.: 2023-009-02
Name : __LE MADONNA JUAN Date of Travel : 4/17, 6/15,20, 8/18,2023
Position : __DISBURSING OFFICER__ Purpose of Travel: attend seminar,Procure school
Official Station : _QUEZON CES___ supplies, Submit liquidation reports ,
Places to be visited TIME Means of Transpor- Per Total
Date INCI
(Destination) Departure Arrival TRANSPO station Diem Amount
MAY17,2023 QUEZON-MLYBLY 6:30AM 8:00AM PUV 155
MAY18,2023 MLYBLY-QUEZON 3:15PM 5PM PUV 155 360 670
JUNE 15,2023 QUEZON-VALENCIA 7AM 8:15AM PUV 80
JUNE 15,2023 VALENCIA-QUEZON 5PM 6:15PM PUV 80 180 340
JUNE 20,2023 QUEZON-MLYBLY 6:15AM 8:00AM PUV 155
JUNE 20,2023 MLYBLY-QUEZON 3PM 6PM PUV 155 360 670
AUG 18,2023 QUEZON-MLYBLY 6:15AM 8:00AM PUV 155
AUG 18,2023 MLYBLY-QUEZON 12PM 3PM PUV 155 360 670
TOTAL 2,350
Prepared by :
I certify that : (1) I have reviewed the foregoing LE MADONNA L. JUAN
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:
TESSIE P. PRESBITERO TESSIE P. PRESBITERO
SCHOOL PRINCIPAL Signature over Printed Name
SCHOOL PRINCIPAL
Appendix 45
ITINERARY OF TRAVEL
Entity Name : QUEZON CENTRAL ELEMENTARY SCHOOL
Fund Cluster: _MOOE No.:
Name : __LE MADONNA JUAN Date of Travel : 9/5,9/8, 9/14, 9/26,2023
Position : __DISBURSING OFFICER__ Purpose of Travel: Submit liquidation reports, Update
Official Station : _QUEZON CES___ passbooks,Procure school supplies, SUBMIT IPCRF
Places to be visited TIME Means of Transpor- Per Total
Date INCI
(Destination) Departure Arrival TRANSPO station Diem Amount
SEPT 5,2023 QUEZON-MLYBLY 6:15AM 8:00AM PUV 155
SEPT 5,2023 MLYBLY-QUEZON 4:15PM 6PM PUV 155 360 670
SEPT 8,2023 QUEZON-MLYBLY 6:15AM 8:00AM PUV 155
SEPT 8,2023 MLYBLY-QUEZON 4:00PM 5:45PM PUV 155 360 670
SEPT 14,2023 QUEZON-MLYBLY 6:15AM 8:00AM PUV 155
SEPT 14,2023 MLYBLY-QUEZON 7:15PM 9PM PUV 155 360 670
SEPT 26,2023 QUEZON-VALENCIA 7AM 8:15AM PUV 80
SEPT 26,2023 VALENCIA-QUEZON 5PM 6:15PM PUV 80 180 340
TOTAL 2,350
Prepared by :
I certify that : (1) I have reviewed the foregoing LE MADONNA L. JUAN
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:
MYRNA S. LACTAOTAO MYRNA S. LACTAOTAO
SCHOOL HEAD Signature over Printed Name
SCHOOL HEAD
Appendix 47
CERTIFICATION OF TRAVEL COMPLETED
Entity Name: QUEZON CENTRAL ELEMENTARY SCHOOL Fund Cluster: MOOE
MYRNA S. LACTAOTAO QUEZON CENTRAL ELEMENTARY SCHOOL
SCHOOL HEAD Station
I HEREBY CERTIFY THAT I have completed the travel as authorized in the Travel Order/
Itinerary of Travel No. ________dated 5/17, 6/15,6/20, 8/18,2023 under conditions
indicated below:
/ x / Strictly in accordance with the approved itinerary.
/ / Cut short as explained below. Excess payment in the amount of
P_______ was refunded under O. R. No. ________ dated __________
/ / Extended as explained below, additional itinerary was submitted
/ / Other deviation as explained below.
Explanation or justifications:
Claimed existing fare rate on Public Utility Buses on national high ways
Evidence of travel:
____________CERTIFICATE OF APPEARANACE
____________TRAVEL ORDER
Respectfully submitted:
LE MADONNA L. JUAN
Name of Employee
On evidence and information of which I have the knowledge, the travel was actually undertaken.
Approved:
MYRNA S. LACTAOTAO
SCHOOL HEAD
Appendix 46
REIMBURSEMENT EXPENSE RECEIPT
Entity Name: _________________ Fund Cluster : ________________
Date : _______________________ RER No. : ___________________
RECEIVED from ______________________________________
(Name)
_________________________________________________ the amount
(Official Designation)
of __________________________________________ (P__________)
(In Words) (in Figures)
in payment for _______________________________________________
(Payments for subsistence, services,
_________________________________________________________
rental or transportation should show inclusive dates,
_________________________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Signature :
Address :
Cedula #
Date of issue:
Place of issue:
WITNESS
Name/Signature :
Address
Cedula #
Date of issue:
Place of issue:
Republic of the Philippines
Department of Education
Region X
DIVISION OF BUKIDNON
Malaybalay City
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017
Name of Employee LE MADONNA L. JUAN Employee 4643940
No.
QUEZON CENTRAL ELEMENTARY SCHOOL
Office
BUKIDNON
Division
Particulars Amount (₱)
MAY17,2023 QUEZON-MLYBLY 155
MAY18,2023 MLYBLY-QUEZON 155
JUNE 15,2023 QUEZON-VALENCIA 80
JUNE 15,2023 VALENCIA-QUEZON 80
JUNE 20,2023 QUEZON-MLYBLY 155
JUNE 20,2023 MLYBLY-QUEZON 155
AUG 18,2023 QUEZON-MLYBLY 155
AUG 18,2023 MLYBLY-QUEZON 155
TOTAL 1,090
Purpose : Procure school supplies, UPDATE PASSBOOK & SUBMIT REPORTS
I hereby certify that the above expenses are incurred as they are necessary for the above cited
purpose, that above good and services were acquired from partied not issuing receipts. And that I
am fully aware that willful falsification of statements is punishable by law.
Certified correct: Noted by:
Signature
LE MADONNA L. JUAN MYRNA S. LACTAOTAO
Printed Name
Employee Immediate Supervisor
Date Date
