DISBURSEMENT VOUCHER LONOY NATIONAL HIGH SCHOOL

Lonoy, Sapian, Capiz

No. Date:

May 3, 2012

CLASSIFICATION OF DISBURSEMENT
Regular Cash Advance Other Payment MDS Check

MODE OF PAYMENT
Commercial Check Cash

Name of Claimant: SONIA L. PINALBA Address: LONOY NATIONAL HIGH SCHOOL, SAPIAN, CAPIZ PARTICULARS To payment of travel expenses while on official travel, as per supporting apers hereto attached in the amount.

ID No./TIN: Responsibility Center: Amount

PHP

1,360.00

Amount Due PHP

A) Certified: Expenses/Cash Advances necessary, lawful and incurred under my direct supervision B) Certified: Supporting documents complete and proper; and ( ) Cash Available ( ) Subject to ADA Signature: Printed Name: Position: D) Received Payment: MILA V. BAYHON Administrative Officer V Signature: Printed Name: JOSEPHINE T. MANUEL Position: Administrative Officer III ZENAIDA O. FACINAL Principal - I Date:__________________________ Check/ADA No.____________Date_______ C) Approved for payment: One Thousand Three Hundred Sixty Pesos Only

1,360.00

Date:_____________________________

1,360.00
Bank Name:__________________________

ALOBS NO.___________Date_______ JEV NO.______________Date_______

SONIA L. PINALBA Signature over Printed Name/Date

O.R. No.______________________________

JOURNAL ENTRY VOUCHER Department of Education - LONOY NATIONAL HIGH SCHOOL

Responsibility Center Accounts and Explanation ACCOUNTING ENTRIES Account Code Ref.

No. Date: Amount Debit Credit

Prepared by:

May 3, 2012
Others

NT

Amount

1,360.00

1,360.00

yment:

ee Hundred Sixty

DA O. FACINAL

rincipal - I

______Date_______

______Date_______

Annex G-3

Amount Credit

APPENDIX A
No.: Date: May 03, 2012

Name: SONIA L. PINALBA Official Station: LONOY NATIONAL HIGH SCHOOL Purpose of Travel: On official Travel Date
March 8, 2012 March 10, 2012 April 24-25, 2012

Position: Monthly Salary: PHP 17,540.00

Place of Visit
Station- Roxas City Station- Roxas City Station- Roxas City

Departure Arrival
6:00 A.M. 6:00 A.M. 6:00 A.M. 7:00 A.M. 7:00 A.M. 7:00 A.M.

Means of Transportation
Jeepney & Tricycle Jeepney & Tricycle Jeepney & Tricycle

Fare
100.00 100.00 200.00

Per Diems
240.00 240.00 480.00

TOTAL (2) (1) I HEREBY CERTIFY THAT I have received the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered is reasonable, (4) the expenses claimed are proper. ZENAIDA O. FACINAL Supervisor/Immediate Supervisor (1) Prepared by:

400.00

960.00

SONIA L. PINALBA Employee

(2) Approved by: ZENAIDA O. FACINAL Principal - I

APPENDIX B
ZENAIDA O. FACINAL (Agency Head) Principal I (Designation) LONOY NATIONAL HIGH SCHOOL (Station) ___________________________ (Date)

I hereby certify that I have completed the travel authorized in the itinerary of Travel No. dated May 3, 2012 under the conditions indicated below. ______________ Strictly in accordance with the prepared itinerary. ______________ Cut short explainrd below Excess payment in the amount _______________________________ was refunded under O.R. No dated___________________________________________________ ______________ Extended as explained below: Additional itinerary was submitted: ______________Other deviations as explained below: _____________________________________________________________________________________________________ Attached supporting documents: Certificate of Appearance, Travel Order

On evidence and information of which I have knowledge, the travel was undertaken. Respectfully submitted: SONIA L. PINALBA Name of Employee Teacher - I Designation

ate: May 03, 2012

Teacher - I ly Salary: PHP 17,540.00

Total
340.00 340.00 680.00

1,360.00

NIA L. PINALBA Employee

IDA O. FACINAL Principal - I

IGH SCHOOL

__________

______________ ________________

_______________________

bmitted:

NIA L. PINALBA me of Employee

Teacher - I Designation

Republic of the Philippines Department Of Education Region VI - Western Visayas DIVISION OF CAPIZ LONOY NATIONAL HIGH SCHOOL Lonoy, sapian, Capiz March 9, 2012

AUTHORITY TO TRAVEL

TO WHOM IT MAY CONCERN:

Authority is hereby granted to Teacher I (Designation) To Travel Date of Travel Purpose: of MRS. SONIA L. PINALBA LONOY NATIONAL HIGH SCHOOL (School) Station 10-Mar-12 To: To: The Division Office (Banica, Roxas City) 10-Mar-12

From: From:

To return the NAT (National Achievement Test) testing materials.

Approved for:

one (1) days

Approved: ZENAIDA O. FACINAL Principal - I