Acknowledgement Receipt
Date: ______________________
Received from: _______________________________________________________________________________________
The Amount of: ______________________________________________________________________________________
______________________________________________________(Php)__________________________
As payment for: ______________________________________________________________________________________
______________________________________________________________________________________
Received by: _______________________________________________
Payee Signature over Printed Name
Address: _______________________________________________
Contact Number _______________________________________________
TIN _______________________________________________
Pailig Representative: __________________________________________
Designation: __________________________________________
(Acknowledgement Receipt is for payment where Official Receipt could not be secured)
REIMBURSEMENT FORM
Name: Position:
Office/Designation: Residence:
Purpose of Travel:
Date Description/Places Time Means of Actual Cost Total
Visited Transportatio
(Destination) Departur Arrival n Fare Meals Lodgin Others
e g
P
Submitted by: Received by:
______________________________ ________________________________
Reviewed by: Approved by:
______________________________________ _______________________________________________
REIMBURSEMENT FORM
Name: Position:
YONILITO NAOJA TRAINER – B3
Office/Designation: Residence:
LA SALLE UNIVERSITY (LSU) OZAMIZ OZAMIZ CITY
Purpose of Travel:
Attendance to TOT – B3 (Go Digital ASEAN PH)
Date Description/Places Time Means of Actual Cost Total
Visited Transportatio
(Destination) Departur Arrival n Fare Meals Lodgin Others
e g
Nov. 30 ABSENT
Dec. 1 350 350.00
Dec. 2 350 350.00
Dec. 3 350 350.00
Dec. 4 350 350.00
Note: Meals reimbursement during TOT – B3
P 1,400.00
Submitted by: Received by:
YONILITO NAOJA YONILITO NAOJA
Reviewed by: Approved by:
______________________________________ _______________________________________________
REIMBURSEMENT FORM
Name: Position:
THEODORA LA REYNA VILLANUEVA TRAINER – B3
Office/Designation: Residence:
LA SALLE UNIVERSITY (LSU) OZAMIZ OZAMIZ CITY
Purpose of Travel:
Attendance to TOT – B3 (Go Digital ASEAN PH)
Date Description/Places Time Means of Actual Cost Total
Visited Transportatio
(Destination) Departur Arrival n Fare Meals Lodgin Others
e g
Nov. 30 ABSENT
Dec. 1 ABSENT
Dec. 2 350 350.00
ABSENT
Dec. 3
ABSENT
Dec. 4
Note: Meals reimbursement during TOT – B3
P 350.00
Submitted by: Received by:
Theodora La Reyna Villaneuva Theodora La Reyna Villanueva
Reviewed by: Approved by:
______________________________________ _______________________________________________
REIMBURSEMENT FORM
Name: Position:
MARY ROSE CUARESMA TRAINER – B3
Office/Designation: Residence:
LA SALLE UNIVERSITY (LSU) OZAMIZ OZAMIZ CITY
Purpose of Travel:
Attendance to TOT – B3 (Go Digital ASEAN PH)
Date Description/Places Time Means of Actual Cost Total
Visited Transportatio
(Destination) Departur Arrival n Fare Meals Lodgin Others
e g
Nov. 30 ABSENT
Dec. 1 350 350.00
Dec. 2 350 350.00
Dec. 3 350 350.00
Dec. 4 ABSENT
Note: Meals reimbursement during TOT – B3
P 1,050.00
Submitted by: Received by:
MARY ROSE CUARESMA MARY ROSE CUARESMA
Reviewed by: Approved by:
______________________________________ _______________________________________________
