Republic of the Philippines APPENDIX A

Province of Aklan
Kalibo, Aklan

PROVINCIAL ASSESSOR OFFICE

DRIVERS TRIP TICKET

June 16, 2022__
Date

To be filled by the Administrative

authorizing Official Travel:

1. Name of driver of the vehicle: NICK YERRO_________________________________

2. Government car to be used, Plate No. SAA7080_______________________________
3. Name of authorized passengers_MICHAEL REBENITO_____________________
4. Place or places to be visited/inspected Malay, Aklan, Aklan____________________
Purpose of Travel CONDUCT SERVICE TO APPRAISAL TEAM.__________

KOKOY B. SOGUILON
Chief of Office or his duly
Authorized Representative
To be filled by the Driver:
1. Time of departure from Office/garage __________________________________ am/pm
2. Time of arrival at (per No. 4 above) ___________________________________ am/pm
3. Time of departure from (per No. 4) ____________________________________ am/pm
4. Time of arrival back to Office/garage ___________________________________ am/pm
5. Approximate distance traveled (to and from) _____________________________ am/pm
6. Gasoline issued, purchase and consumed:
a. Balance in tank __________________________________ ltrs.
b. Issued by Office from stock _____________ ________________ ltrs.
TOTAL ____________________________ ltrs.
c. Deduct: Used during the trip (to and from) _____________ ltrs.
d. Balance in tank during the end of the trip _______________ ltrs.
7. Gear oil issued ___________________________________________________ ltrs.
8. Motor oil issued __________________________________________________ ltrs.
9. Brake fluid issued ________________________________________________ ltrs.
10. Grease oil issued _________________________________________________ ltrs.
11. Speedometer reading, if any
At beginning of the trip ______________________________________ kms.
At the end of the trip _______________________________________ kms.
12. Remarks:
I hereby certify that I used this car on official business as stated above.

__________________

Driver

NAME OF PASSENGER:

Kokoy B. Soguilon Janet B. Alzaga Michael Rebenito Erwin D. Tang

 Republic of the Philippines Control No: _________
Province of Aklan
Kalibo, Aklan

AKLAN PROVINCIAL TOURISM OFFICE

DRIVERS TRIP TICKET

_____________________
Date

To be filled by the Administrative

authorizing Official Travel:

5. Name of driver of the vehicle: ____________________________________________

6. Government car to be used, Plate No. _____________________________________
7. Name of authorized passengers __________________________________________
8. Place or places to be visited/inspected _____________________________________
_____________________________________________________________________
9. Purpose of Travel ______________________________________________________
_____________________________________________________________________

___________________________
Chief of Office or his duly
Authorized Representative
To be filled by the Driver:
13. Time of departure from Office/garage __________________________________ am/pm
14. Time of arrival at (per No. 4 above) ___________________________________ am/pm
15. Time of departure from (per No. 4) ____________________________________ am/pm
16. Time of arrival back to Office/garage ___________________________________ am/pm
17. Approximate distance traveled (to and from) _____________________________ am/pm
18. Gasoline issued, purchase and consumed:
a. Balance in tank ___________________________________ ltrs.
b. Issued by Office from stock _________________________ ltrs.
c. Add purchased during trip___________________________ ltrs.
TOTAL _______________________ ltrs.
d. Deduct: Used during the trip (to and from) _____________ ltrs.
e. Balance in tank during the end of the trip _______________ ltrs.
19. Gear oil issued ___________________________________________________ ltrs.
20. Motor oil issued __________________________________________________ ltrs.
21. Brake fluid issued ________________________________________________ ltrs.
22. Grease oil issued _________________________________________________ ltrs.
23. Speedometer reading, if any
At beginning of the trip ______________________________________ kms.
At the end of the trip _______________________________________ kms.
24. Remarks:
I hereby certify that I used this car on official business as stated above.

Passenger:
_______________________________________
_______________________________________
___________________________
Driver
________________________________
________________________________
_______________________________________ ________________________________