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APPENDIX "A"

Date
LGU - SAN JOSE
Agency

ITINERARY OF TRAVEL

Name: Pablo delos Santos


Position: Punong Barangay
Official Station: Camagong, San Jose, Camarines Sur
Purpose: Please see attached approved travel order
Date Time Allowable Expenses
Total
Place to be Visited Transp. Per Diems/ Lodging
2008 Departure Arrival Trans Amount
inc. exp. Exp.
Dec. 10 OS - Naga 6am 7am Van 80.00 80.00
Naga-Manila 8:30am 6:30pm Bus 700.00 160.00 860.00
Term.-Temp.Res. Taxi 200.00 200.00
11 to 13 In Manila 2,400.00 2,400.00
Dec. 14 Temp. res.-terminal 6am 7am Taxi 200.00 200.00
Mla-Naga 8:30am 6:30pm Bus 700.00 160.00 860.00
Naga -OS 6:30pm 7:30pm Van 80.00 80.00
Total 4,680.00

(2) Icertify that: (1) I have reviewed the foregoing (1) Prepared by:
Itinerary. (2) The travel is necessary to the
service. (3) The period covered is reasonable PABLO DELOS SANTOS
(4) The expenses claimed are properly set forth. (Official or Employee)

Recommending Approval: APPROVED BY:

HON GILMAR S. PACAMARRA


Municipal Mayor
DISBURSEMENT VOUCHER
San Jose, Camarines Sur Date:
LGU
CLASSIFICATION OF DISBURSEMENT

MDS Check Commercial Check Other Payments


Name of Claimant:

Address:

Particulars Amount

A Certified Expsenses/Cash Advances B Certified supporting documents C Approved for Payment


necessary, lawful and, incurred under complete and proper, and
my direct supervision.
Cash Available
Signature: Subject to ADA
Printed Name:
Position: IMELDA G. CABALLERO GILMAR S. PACAMARRA
Municipal Accountant Head of Agency/Authorized Representative
Received Payment Payment

Check No.: OBS No. _____ Date: _________


Signature Over Printed Name Bank Name: JEV No.______ Date: _________
Date:
OBLIGATIONS SLIP No.
(OBS) Date:
Payee/Office
Address:
PARTICULARS Account Code Amount

TOTAL

Requested by: Funds Available:

Certified Charged to appropriation/allotment Certified: Appropriation/allotment available and


necessary lawful and under my direct obligated for purpose as indicateed above.
supervision.

HON. GILMAR S. PACAMARRA MARIKO LAURA F. MILANTE


Municipal Mayor Municipal Budget Officer

Date: Date: