Department of Education Region V DIVISION OF CAMARINES SUR Freedom Sport Complex, San Jose, Pili, Camarines Sur APPENDIX

B CERTIFICATE OF TRAVEL COMPLETED EMMA I. CORNEJO Agency Head DepEd, Camarines Sur__ Address

School Division Superintendent Designation

_______________________ Date

I hereby certify that I have completed the travel authorized in the itinerary of travel dated ________________ under condition indicated below. ( ) Strictly in accordance with the approved itinerary ( ) Cut short as explained below. Excess payment in the amount of _______________ as refunded under O.R. No. ______________ Dated __________________ ( ) Other deviation as explained below Explanation or justification below: Memo______________________ Certificate of Appearance_______ ___________________________ ___________________________ Respectfully yours, _______________________

On evidence and information of which I have knowledge, travel was actually undertaken.

_______________________ EUFROSINA P. SABANDO Immediate Supervisor

Republic of the Philippines DEPARTMENT OF EDUCATION DIVISION OF CAMARINES SUR Freedom Sport Complex, San Jose, Pili, Camarines Sur

OBLIGATION REQUEST
Payee Office Address
Responsibility Center

No.

Particulars

P.P.A.

Account Code

Amount

Total A. Certified
Charges to appropriation/allotment necessary, lawful and under my direct supervision Supporting documents valid, proper and legal

B.

Certified
Allotment available and obligated for the purpose As indicated above

Signatur e Printed Name Position Date

Signature EUFROSINA P. SABANDO ASDS

Head requesting Office/Authorized Representative

Printed Name Position Date

SONIA M.LASALA Accountant II

Head Budget Unit/Authorized Representative

DEPARTMENT OF EDUCATION DIVISION OF CAMARINES SUR Freedom Sport Complex, San Jose, Pili, Camarines Sur

DISBURSEMENT VOUCHER
Mode of Payment Payee Address
MDS Check Commercial Check ADA
TIN/Employee No.

No.

Others
OR/BUR No.

PEDRO J. PELONIO et al
Pagatpat Calabanga, Camarines Sur

Responsibility Center
Office/Unit/Project Code

EXPLANATION

AMOUNT

A.

Certified
Cash available Subject to Authority to Debit Accountant (when Applicable) Supporting documents complete

B.

Approved for Payment

Signature Printed Name Position Date C. Received Payment Date Date SONIA M. LASALA
Accountant II
Head Accounting Unit/Authorized Representative

Signature Printed Name Position Date JEV No. Bank Name Printed Name Date EMMA I. CORNEJO
Schools Division Superintendent
Agency Head/Authorized Representative

Check/ ADA No. Signature