`

A P P E N D I X “B”

CERTIFICATE OF TRAVEL COMPLETED

ELENA M. DIEZA Hinabangan, Samar

(Head of Agency) (Station)

Municipal Mayor ________________

(Designation) (D a t e)

I HEREBY CERTIFY that I have completed the travel authorized in

the Itinerary of Travel No. _____ dated _______ under conditioned indicated below.
/ / - Strictly as in accordance with approved itinerary.
/ / - Cut Short as explained below Exceed payment in the amount of
Php ________ was refunded on O.R. No. _____ dated
__________.
/ / - Extended as explained below additional itinerary was submitted.
/X/ - Other deviations as explained below.

Explanation of Justifications:

Evidence of Travel:
/x/ - Used Tickets
/x/ - Certificate of Appearance
/x/ - Registration fee

Respectfully submitted:

REX DACANAY
(Official/Employee)

On evidence or information of which I have knowledge, the travel was

actually not undertaken.

ELENA M. DIEZA
Municipal Mayor
 A P P E N D I X “B”

CERTIFICATE OF TRAVEL COMPLETED

ELENA M. DIEZA Hinabangan, Samar

(Head of Agency) (Station)

Municipal Mayor ________________

(Designation) (D a t e)

I HEREBY CERTIFY that I have completed the travel authorized in

the Itinerary of Travel No. _____ dated _______ under conditioned indicated below.
/ / - Strictly as in accordance with approved itinerary.
/ / - Cut Short as explained below Exceed payment in the amount of
Php ________ was refunded on O.R. No. _____ dated
__________.
/ / - Extended as explained below additional itinerary was submitted.
/X/ - Other deviations as explained below.

Explanation of Justifications:

Evidence of Travel:
/x/ - Used Tickets
/x/ - Certificate of Appearance
/x/ - Registration fee

Respectfully submitted:

VIRGINIA B. CARDENAS
(Official/Employee)

On evidence or information of which I have knowledge, the travel was

actually not undertaken.

ELENA M. DIEZA
Municipal Mayor
 A P P E N D I X “B”

CERTIFICATE OF TRAVEL COMPLETED

ELENA M. DIEZA Hinabangan, Samar

(Head of Agency) (Station)

Municipal Mayor ________________

(Designation) (D a t e)

I HEREBY CERTIFY that I have completed the travel authorized in

the Itinerary of Travel No. _____ dated _______ under conditioned indicated below.
/ / - Strictly as in accordance with approved itinerary.
/ / - Cut Short as explained below Exceed payment in the amount of
Php ________ was refunded on O.R. No. _____ dated
__________.
/ / - Extended as explained below additional itinerary was submitted.
/X/ - Other deviations as explained below.

Explanation of Justifications:

Evidence of Travel:
/x/ - Used Tickets
/x/ - Certificate of Appearance
/x/ - Registration fee

Respectfully submitted:

CLARITA D. GAVION
(Official/Employee)

On evidence or information of which I have knowledge, the travel was

actually not undertaken.

ELENA M. DIEZA
Municipal Mayor
 A P P E N D I X “B”

CERTIFICATE OF TRAVEL COMPLETED

CLARITO P. ROSAL Hinabangan, Samar

(Head of Agency) (Station)

Municipal Mayor ________________

(Designation) (D a t e)

I HEREBY CERTIFY that I have completed the travel authorized in

the Itinerary of Travel No. _____ dated _______ under conditioned indicated below.
/ / - Strictly as in accordance with approved itinerary.
/ / - Cut Short as explained below Exceed payment in the amount of
Php ________ was refunded on O.R. No. _____ dated
__________.
/ / - Extended as explained below additional itinerary was submitted.
/X/ - Other deviations as explained below.

Explanation of Justifications:

Evidence of Travel:
/x/ - Used Tickets
/x/ - Certificate of Appearance
/x/ - Registration fee

Respectfully submitted:

REX DACANAY
(Official/Employee)

On evidence or information of which I have knowledge, the travel was

actually not undertaken.

HON. CLARITO P. ROSAL

Acting Municipal Mayor
 A P P E N D I X “B”

CERTIFICATE OF TRAVEL COMPLETED

CLARITO P. ROSAL Hinabangan, Samar

(Head of Agency) (Station)

Acting Municipal Mayor ______________

(Designation) (D a t e)

I HEREBY CERTIFY that I have completed the travel authorized in

the Itinerary of Travel No. _____ dated _______ under conditioned indicated below.
/ / - Strictly as in accordance with approved itinerary.
/ / - Cut Short as explained below Exceed payment in the amount of
Php ________ was refunded on O.R. No. _____ dated
__________.
/ / - Extended as explained below additional itinerary was submitted.
/X/ - Other deviations as explained below.

Explanation of Justifications:

Evidence of Travel:
/x/ - Used Tickets
/x/ - Certificate of Appearance
/x/ - Registration fee

Respectfully submitted:

VIRGINIA B. CARDENAS
(Official/Employee)

On evidence or information of which I have knowledge, the travel was

actually not undertaken.

HON. CLARITO P. ROSAL

Acting Municipal Mayor