Republic of the Philippines

Department of Transportation
LAND TRANSPORTATION OFFICE
Regional Office No. VII

Control No. SAA3885-068

____________________________
Date

VEHICLE’S TRIP TICKET

A. To be filled by the Division/Section Heads requesting Transportation:

1. Name of the Authorized Passengers:__________________________________________
2. Place(s) to be visited:______________________________________________________
3. Purpose of Trip: __________________________________________________________
4. Appropriate time Vehicle Needed: ____________________________________________
5. Appropriate time of Return:_________________________________________________

APPROVED:

________________________ _______________________
Administrative Officer Requesting Officer

B. To be filled by officer authorizing the use of vehicles:

1. Name of the Driver of Vehicle: ______________________________________________
2. Government Car to be used: Plate No. ________________________________

C. To be filled by driver of vehicle used:

1. Time of Departure from Garage: _________________A.M/P.M.____________________
2. Time of Arrival Back to Office: _________________A.M./P.M._______________
3. Appropriate Distance Travelled to & Back __________________________Kms/liter
a) Balance in tank before trip ___________________________ liters
b) Issued by office from stock ___________________________ liters
c) Add: Purchases during trip ___________________________ liters
d) Total ___________________________ liters
e) Deduct: total used during trip ___________________________ liters
f) Balance in tank at end of trip ___________________________ liters

ODOMETER READINGS:

 At the end of the trip: _______________________________ liters

 At the beginning of trip ______________________________ liters

PURCHASES MADE DURING TRIP

Date Number of Liters Motor Oil Tire Service Invoice Number_______

___________ _______________ _____________ ______________ ____________________
___________ _______________ _____________ ______________ ____________________
___________ _______________ _____________ ______________ ____________________

______________________
Driver

______________________
Passenger

______________________
Passenger

Natalio Bacalso Avenue, Telefax: (032) 256-2745

Cebu City Telephone: (032) 266-1304
6000 lto7actioncenter@gmail.com
www.lto.gov.ph