APPENDIX "A"

Department of Education
Division of Dumaguete City
NAME OF SCHOOL
Dumaguete City

ITINERARY OF TRAVEL

Name: Position:
Monthly Salary: Official Station:
Purpose of Travel:

Means of Allowable Expenses

Date Places to be visited Departure Arrival Transpor- Traspor- Hotel/ Meals Indicental Total
tation tation Lodging Expenses
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

TOTAL 0.00 0.00 0.00 0.00 0.00

I certify that: (1) I have reviewed the foregoing Prepared by:

itinerary; (2) that the travel is necessary to the
service; (3) the period covered is reasonable;
(4) the expenses claimed are proper.
Employee

Administrative Officer Designate Approved by:

Principal
 APPENDIX "B"

DEPED, DIVISION OF DUMAGUETE CITY

Agency

CERTIFICATE OF TRAVEL COMPLETED

Principal Official Station

Designation Date

I CERTIFY that I have completed the travel authorized in itinerary of Travel No. ____
s.____ dated under the conditions stated below:

( / ) Strictly in accordance with approved itinerary

( ) Cut short as explained below. Excess payment in the amount of
(P ) was refunded per O.R. No. dated .

Explanation or Justification:

Evidences of travel hereto attached: Memo, Ticket, Travel Order, Appearance, etc.

Officer/Employee/Student

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

Principal
Note: Please supply necessary data and edit names/positions of signatories as well as the heading of the form (name of
mes/positions of signatories as well as the heading of the form (name of school)