DEPED - DIVISION OF TARLAC PROVINCE Fund Cluster :

Entity Name 01-REGULAR

Date : 2/17/2022
DISBURSEMENT VOUCHER DV No. : 2022-07-

Mode of MDS Check Commercial Check ADA Others (Please specify)

Payment
_________________

Payee HOBERT T. SALAZAR TRANSPORT SERVICE TIN/Employee No.: ORS/BURS No.:

406-048-102-000
Address #17 Canan, Paniqui, Tarlac

Responsibility
Particulars MFO/PAP Amount
Center

To payment of Travel Expenses of SAN MIGUEL

14,700.00
ELEMENTARY SCHOOL STAFF of SAN MIGUEL
ELEM. SCHOOL for the month of JULY 2022, as per
attached supporting documents in the amount of ……..

Amount Due 14,700.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

MA. TERESA G. MANALANSAN

School Administraive Officer

B. Accounting Entry:
Account Title UACS Code Debit Credit
Traveling Expenses - Local 5020101000 15,000.00
Due to BIR 2020101000 300.00
Advances for Operating Expenses 1990101000 14,700.00
C. Certified: D. Approved for Payment
Cash available
Subject to Authority to Debit Account (when applicable)
Fourteen thousand seven hundred pesos only
Supp
proper

Signature Signature

Printed
Printed Name
Name OFELIA H. DE GUZMAN RHODORA R. STO. DOMINGO

Administrative Assisstant III Principal I

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date 07/ /2022 Date 07/ /2022

E. Receipt of Payment JEV No.
Date : 02/17/2022 Bank Name & Account Number:
Check/
ADA No. : 353486 LBP CPN 1612-
1031-74
Date : 02/17/2022 Printed Name: Date
Signature : HOBERT T. SALAZAR
TRANSPORT SERVICE
Official Receipt No. & Date/Other Documents
 Appendix 45

ITINERARY OF TRAVEL

Entity Name : DepEd - Schools Division of Tarlac Province

Fund Cluster: 01-REGULAR No.: 2022-07-00

Name : SAN MIGUEL ELEMENTARY SCHOOL STAFF Date of Travel : JULY 30-31, 2022
Position : Purpose of Travel :
Official Station : SAN MIGUEL ELEMENTARY SCHOOL Submit Itinerary of Travel Completed
STA.INES JUNIOR HIGH SCHOOL Submit different reports
Places to be visited TIME Means of Transpor- Per Registration
Date
(Destination) Departure Arrival Transportation station Diem Fee Total Amount

07-30-2022 SUCLAYIN, BALER, AURORA 4:00 AM 12:00 NN Various 7,500.00 7,500.00

07-31-2022 SAN MIGUEL ELEMENTARY SCHOOL 4:00 PM 12:00 MN Various 7,500.00 7,500.00

-
-
-

TOTAL 15,000.00 - - 15,000.00

Prepared by :

I certify that : (1) I have reviewed the foregoing itinerary, (2) RHODORA R. STO. DOMINGO,PhD
the travel is necessary to the service, (3) the period covered is Principal I
reasonable and (4) the expenses claimed are proper.

Approved by:

ARMANDO C. CAPILI EdD

Assistant Schools Division Superintendent
Agency Head/Authorized Representative
 Appendix 47

CERTIFICATION OF TRAVEL COMPLETED

Entity Name: SAN MIGUEL ELEMENTARY SCHOOL Fund Cluster: 01-REGULAR

RONALDO A. POZON,PhD., CESO V DepEd - Schools Division of Tarlac Province

OIC -Schools Division Superintendent Station

I HEREBY CERTIFY THAT I have completed the travel as authorized in the

Travel Order/Itinerary of Travel No. Dated JULY 30-31, 2022 under
conditions indicated below:
/ x / Strictly in accordance with the approved itinerary.
/ / Cut short as explained below. Excess payment in the amount of
P_______ was refunded under O. R. No. ________ dated __________
/ / Extended as explained below, additional itinerary was submitted
/ / Other deviation as explained below.

Explanation or justifications:
Submit itinerary of Travel Completed
Submit different reports
Evidence of travel:
CERTIFICATE OF APPEARANCE
APPROVED TRAVEL ORDER
APPROVED DISBURSEMENT VOUCHER

Respectfully submitted:

RHODORA R. STO. DOMINGO PhD

Principal I

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

Approved:

ARMANDO C. CAPILI EdD

Asst. Schools Division Superintendent
Agency Head/Authorized Representative