Republic of the Philippines

DEPARTMENT OF AGRICULTURE
Regional Field Unit No. VIII
Tacloban City
Date:
Trip Ticket No.:
VEHICLE TRIP TICKET

Instructions: 1. To be filled in duplicate by person requesting use of the department vehicle.

2. Original to driver and to be returned to the Administrative Services Section upon completion.
3. Duplicate to Administrative Services Section for control.

TO BE FILLED BY PERSONNEL REQUESTING USE OF DEPARTMENT VEHICLE:

DRIVER'S NAME: VEHICLE PLATE NO. :

DEPARTURE DATE: RETURN DATE :
AUTHORIZED PASSENGER/S:

DESTINATION:

PURPOSE:

RECOMMEDING APPROVAL:

Supply Officer II Acting Chief-Admin. & Finance

TO BE FILLED BY DRIVERS AFTER THE END OF THE TRIP:

TRIP NO. DEPARTURE: ARRIVAL:

TIME: PLACE: TIME: PLACE:

BALANCE IN TANK. . . . . . . . . . . . . . . . . . . . liters

ISSUED FROM STOCK. . . . . . . . . . . . . . . . . liters CERTIFIED CORRECT:
PURCHASED OUTSIDE . . . . . . . . . . . . . . . . liters
TOTAL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . liters
USED DURING THE TRIP. . . . . . . . . . . . . . .. liters
BALANCE IN TANK. . . . . . . . . . . . . . . . . . . . liters
GEAR OIL USED.. . . . . . . . . . . . . . . . . . . . . liters (Driver)
MOTOR OIL USED. . . . . . . . . . . . . . . . . . . .. liters
BRAKE FLUID. . . . . . . . . . . . . . . . . . . . . . .. liters
GREASE. . . . . . . . . . . . . . . . . . . . . . . . . . . lbs.
TOTAL DISTANCE TRAVELLED. . . . . . . . . .. kms.
REMARKS:

I hereby certify that the above vehicle was used on official business as stated above.

PASSENGER PASSENGER PASSENGER

PASSENGER PASSENGER PASSENGER

 Republic of the Philippines
RTMENT OF AGRICULTURE
Regional Field Unit No. VIII
Tacloban City

VEHICLE TRIP TICKET

NNEL REQUESTING USE OF DEPARTMENT VEHICLE: