Republic of the Philippines

Province of Nueva Vizcaya

MUNICIPALITY OF BAMBANG
-o0o-
OFFICE OF THE SANGGUNIANG BAYAN

November 22, 2016

DRIVERS TRIP TICKET No. 2016 ________

Name of Driver: ROBERT U. SIERRA

Plate No.: SAA 5153
Type of Vehicle: Toyota GL Grandia.
Name of Authorized Passenger/s:
Places to be visited/inspected: _____________________________________________________
Purpose: To CSC Field Office, Bayombong, Nueva Vizcaya.
Time of Departure: _____________________Time of Arrival:____________________________
Distance Travelled: __________________________________________________________kms.

Gasoline:
a) Balance in tank 6 liters
b) Add. Purchase as per PO/PR 30 liters
c) Less: Used during trip _____________liters
d) Balance in tank at the end of the trip _____________liters

Certified correct: Recommended by:

ROBERT U. SIERRA ARNEL WENCESLAO Z. HERNANDEZ

Driver Vice Mayor & Presiding Officer
APPROVED:

REGGIE G. CABARAL ARNEL WENCESLAO Z. HERNANDEZ

SB Secretary Municipal Vice Mayor & Presiding Officer