 

MM/DD/YYYY REQUEST DATE:____/____/______ MM/DD/YYYY REQUEST DATE:____/____/______

CLEARANCE AUTHORITY to TRAVEL CLEARANCE AUTHORITY to TRAVEL
Others:___________ DONE/DATE:__/__/____ Others:___________ DONE/DATE:__/__/____
Full name: Full name:

Position Office Assignment Position Office Assignment

Purpose: Purpose:
Contact No.: Contact No.:
Note: Authority to Travel – must have an application letter, signed and Note: Authority to Travel – must have an application letter, signed and
noted OKAY by the City Mayor. He/she must also present a leave application noted OKAY by the City Mayor. He/she must also present a leave application
for the travel. for the travel.
 

 

MM/DD/YYYY REQUEST DATE:____/____/______ MM/DD/YYYY REQUEST DATE:____/____/______

CLEARANCE AUTHORITY to TRAVEL CLEARANCE AUTHORITY to TRAVEL
Others:___________ DONE/DATE:__/__/____ Others:___________ DONE/DATE:__/__/____
Full name: Full name:

Position Office Assignment Position Office Assignment

Purpose: Purpose:

Contact No.: Contact No.:

Note: Authority to Travel – must have an application letter, signed and Note: Authority to Travel – must have an application letter, signed and
noted OKAY by the City Mayor. He/she must also present a leave application noted OKAY by the City Mayor. He/she must also present a leave application
for the travel. for the travel.
 

 

MM/DD/YYYY REQUEST DATE:____/____/______ MM/DD/YYYY REQUEST DATE:____/____/______

CLEARANCE AUTHORITY to TRAVEL CLEARANCE AUTHORITY to TRAVEL
Others:___________ DONE/DATE:__/__/____ Others:___________ DONE/DATE:__/__/____
Full name: Full name:

Position Office Assignment Position Office Assignment

Purpose: Purpose:

Contact No.: Contact No.:

Note: Authority to Travel – must have an application letter, signed and Note: Authority to Travel – must have an application letter, signed and
noted OKAY by the City Mayor. He/she must also present a leave application noted OKAY by the City Mayor. He/she must also present a leave application
for the travel. for the travel.
 

 

MM/DD/YYYY REQUEST DATE:____/____/______ MM/DD/YYYY REQUEST DATE:____/____/______

CLEARANCE AUTHORITY to TRAVEL CLEARANCE AUTHORITY to TRAVEL
Others:___________ DONE/DATE:__/__/____ Others:___________ DONE/DATE:__/__/____
Full name: Full name:

Position Office Assignment Position Office Assignment

Purpose: Purpose:
Contact No.: Contact No.:
Note: Authority to Travel – must have an application letter, signed and Note: Authority to Travel – must have an application letter, signed and
noted OKAY by the City Mayor. He/she must also present a leave application noted OKAY by the City Mayor. He/she must also present a leave application
for the travel. for the travel.
 