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Republic of the Philippines

Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF BOHOL
DISTRICVT OF GARCIA-HERNANDEZ
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee
DESIREE M. AMOT STUDENT
Employee No.
Office Name DEPARTMENT OF EDUCATION
Division DIVISION OF BOHOL
District DISTRICT OF GARCIA-HERNANDEZ
Particular Amount (₱)

April 6,2022 Van from Garcia-Hernandez to Sierra Bullones 160.00


BREAKFAST 160.00
Snacks 25.00
LUNCH 160.00
Snacks 25.00
DINNER 160.00
April 7, 2022 Breakfast 160.00
Snacks 25.00
Lunch 160.00
Snacks 20.00
DINNER 160.00
Van from Sierra Bullones to Garcia-Hernandez 160.00
TOTAL 1,375.00

Purpose: TO ATTEND THE DIVISION SCHOOL PRESS CONFERENCE 2022

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and services were acquired
from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.

Certified Correct: Noted by:

Signature

DESIREE M.AMOT MA. GINA G. HORNIDO


STUDENT PRINCIPAL
Date 8/4/2022 Date 04/082022
Republic of the Philippines
Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF BOHOL
DISTRICVT OF GARCIA-HERNANDEZ
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee
ANGEL MAE M. TADLIP STUDENT
Employee No.
Office Name DEPARTMENT OF EDUCATION
Division DIVISION OF BOHOL
District DISTRICT OF GARCIA-HERNANDEZ
Particular Amount (₱)

April 6,2022 Van from Garcia-Hernandez to Sierra Bullones 160.00


BREAKFAST 160.00
Snacks 25.00
LUNCH 160.00
Snacks 25.00
DINNER 160.00
April 7, 2022 Breakfast 160.00
Snacks 25.00
Lunch 160.00
Snacks 20.00
DINNER 160.00
Van from Sierra Bullones to Garcia-Hernandez 160.00
TOTAL 1,375.00

Purpose: TO ATTEND THE DIVISION SCHOOL PRESS CONFERENCE 2022

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and services were acquired
from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.

Certified Correct: Noted by:

Signature

ANGEL MAE M. TADLIP MA. GINA G. HORNIDO


STUDENT PRINCIPAL
Date 8/4/2022 Date 04/082022
Republic of the Philippines
Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF BOHOL
DISTRICVT OF GARCIA-HERNANDEZ
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee
MARYMAE G. OCHAVEZ STUDENT
Employee No.
Office Name DEPARTMENT OF EDUCATION
Division DIVISION OF BOHOL
District DISTRICT OF GARCIA-HERNANDEZ
Particular Amount (₱)

April 6,2022 Van from Garcia-Hernandez to Sierra Bullones 160.00


BREAKFAST 160.00
Snacks 25.00
LUNCH 160.00
Snacks 25.00
DINNER 160.00
April 7, 2022 Breakfast 160.00
Snacks 25.00
Lunch 160.00
Snacks 20.00
DINNER 160.00
Van from Sierra Bullones to Garcia-Hernandez 160.00
TOTAL 1,375.00

Purpose: TO ATTEND THE DIVISION SCHOOL PRESS CONFERENCE 2022

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and services were acquired
from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.

Certified Correct: Noted by:

Signature

MARYMAE G. OCHAVEZ MA. GINA G. HORNIDO


STUDENT PRINCIPAL
Date 8/4/2022 Date 04/082022
Republic of the Philippines
Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF BOHOL
DISTRICVT OF GARCIA-HERNANDEZ
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee
RENIEL D. MAGDAYO STUDENT
Employee No.
Office Name DEPARTMENT OF EDUCATION
Division DIVISION OF BOHOL
District DISTRICT OF GARCIA-HERNANDEZ
Particular Amount (₱)

April 6,2022 Van from Garcia-Hernandez to Sierra Bullones 160.00


BREAKFAST 160.00
Snacks 25.00
LUNCH 160.00
Snacks 25.00
DINNER 160.00
April 7, 2022 Breakfast 160.00
Snacks 25.00
Lunch 160.00
Snacks 20.00
DINNER 160.00
Van from Sierra Bullones to Garcia-Hernandez 160.00
TOTAL 1,375.00

Purpose: TO ATTEND THE DIVISION SCHOOL PRESS CONFERENCE 2022

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and services were acquired
from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.

Certified Correct: Noted by:

Signature

RENIEL D. MAGDAYO MA. GINA G. HORNIDO


STUDENT PRINCIPAL
Date 8/4/2022 Date 04/082022
Republic of the Philippines
Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF BOHOL
DISTRICVT OF GARCIA-HERNANDEZ
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee
JOHN KENNETH P. ERASMO STUDENT
Employee No.
Office Name DEPARTMENT OF EDUCATION
Division DIVISION OF BOHOL
District DISTRICT OF GARCIA-HERNANDEZ
Particular Amount (₱)

April 6,2022 Van from Garcia-Hernandez to Sierra Bullones 160.00


BREAKFAST 160.00
Snacks 25.00
LUNCH 160.00
Snacks 25.00
DINNER 160.00
April 7, 2022 Breakfast 160.00
Snacks 25.00
Lunch 160.00
Snacks 20.00
DINNER 160.00
Van from Sierra Bullones to Garcia-Hernandez 160.00
TOTAL 1,375.00

Purpose: TO ATTEND THE DIVISION SCHOOL PRESS CONFERENCE 2022

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and services were acquired
from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.

Certified Correct: Noted by:

Signature

JOHN KENNETH P. ERASMO MA. GINA G. HORNIDO


STUDENT PRINCIPAL
Date 8/4/2022 Date 04/082022
Republic of the Philippines
Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF BOHOL
DISTRICVT OF GARCIA-HERNANDEZ
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee
EMERSON S. BAUTISTA STUDENT
Employee No.
Office Name DEPARTMENT OF EDUCATION
Division DIVISION OF BOHOL
District DISTRICT OF GARCIA-HERNANDEZ
Particular Amount (₱)

April 6,2022 Van from Garcia-Hernandez to Sierra Bullones 160.00


BREAKFAST 160.00
Snacks 25.00
LUNCH 160.00
Snacks 25.00
DINNER 160.00
April 7, 2022 Breakfast 160.00
Snacks 25.00
Lunch 160.00
Snacks 20.00
DINNER 160.00
Van from Sierra Bullones to Garcia-Hernandez 160.00
TOTAL 1,375.00

Purpose: TO ATTEND THE DIVISION SCHOOL PRESS CONFERENCE 2022

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and services were acquired
from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.

Certified Correct: Noted by:

Signature

EMERSON S. BAUTISTA MA. GINA G. HORNIDO


STUDENT PRINCIPAL
Date 8/4/2022 Date 04/082022
Republic of the Philippines
Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF BOHOL
DISTRICVT OF GARCIA-HERNANDEZ
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee
CHRISTINE JANE PAGARAN STUDENT
Employee No.
Office Name DEPARTMENT OF EDUCATION
Division DIVISION OF BOHOL
District DISTRICT OF GARCIA-HERNANDEZ
Particular Amount (₱)

April 6,2022 Van from Garcia-Hernandez to Sierra Bullones 160.00


BREAKFAST 160.00
Snacks 25.00
LUNCH 160.00
Snacks 25.00
DINNER 160.00
April 7, 2022 Breakfast 160.00
Snacks 25.00
Lunch 160.00
Snacks 20.00
DINNER 160.00
Van from Sierra Bullones to Garcia-Hernandez 160.00
TOTAL 1,375.00

Purpose: TO ATTEND THE DIVISION SCHOOL PRESS CONFERENCE 2022

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and services were acquired
from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.

Certified Correct: Noted by:

Signature

CHRISTINE JANE PAGARAN MA. GINA G. HORNIDO


STUDENT PRINCIPAL
Date 8/4/2022 Date 04/082022
Republic of the Philippines
Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF BOHOL
DISTRICVT OF GARCIA-HERNANDEZ
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee
LOUISE MAE CADIZ STUDENT
Employee No.
Office Name DEPARTMENT OF EDUCATION
Division DIVISION OF BOHOL
District DISTRICT OF GARCIA-HERNANDEZ
Particular Amount (₱)

April 6,2022 Van from Garcia-Hernandez to Sierra Bullones 160.00


BREAKFAST 160.00
Snacks 25.00
LUNCH 160.00
Snacks 25.00
DINNER 160.00
April 7, 2022 Breakfast 160.00
Snacks 25.00
Lunch 160.00
Snacks 20.00
DINNER 160.00
Van from Sierra Bullones to Garcia-Hernandez 160.00
TOTAL 1,375.00

Purpose: TO ATTEND THE DIVISION SCHOOL PRESS CONFERENCE 2022

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and services were acquired
from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.

Certified Correct: Noted by:

Signature

LOUISE MAE CADIZ MA. GINA G. HORNIDO


STUDENT PRINCIPAL
Date 8/4/2022 Date 04/082022
Republic of the Philippines
Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF BOHOL
DISTRICVT OF GARCIA-HERNANDEZ
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee
MARC GLEN P. AROY STUDENT
Employee No.
Office Name DEPARTMENT OF EDUCATION
Division DIVISION OF BOHOL
District DISTRICT OF GARCIA-HERNANDEZ
Particular Amount (₱)

April 6,2022 Van from Garcia-Hernandez to Sierra Bullones 160.00


BREAKFAST 160.00
Snacks 25.00
LUNCH 160.00
Snacks 25.00
DINNER 160.00
April 7, 2022 Breakfast 160.00
Snacks 25.00
Lunch 160.00
Snacks 20.00
DINNER 160.00
Van from Sierra Bullones to Garcia-Hernandez 160.00
TOTAL 1,375.00

Purpose: TO ATTEND THE DIVISION SCHOOL PRESS CONFERENCE 2022

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and services were acquired
from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.

Certified Correct: Noted by:

Signature

MARC GLEN P. AROY MA. GINA G. HORNIDO


STUDENT PRINCIPAL
Date 8/4/2022 Date 04/082022
Republic of the Philippines
Department of Education
Region VII, Central Visayas
SCHOOLS DIVISION OF BOHOL
DISTRICVT OF GARCIA-HERNANDEZ
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee
JOHN MC RAE D. RACINES 6075600
Employee No.
Office Name DEPARTMENT OF EDUCATION
Division DIVISION OF BOHOL
District DISTRICT OF GARCIA-HERNANDEZ
Particular Amount (₱)

April 6,2022 Van from Garcia-Hernandez to Sierra Bullones 160.00


BREAKFAST 160.00
Snacks 25.00
LUNCH 160.00
Snacks 25.00
DINNER 160.00
April 7, 2022 Breakfast 160.00
Snacks 25.00
Lunch 160.00
Snacks 20.00
DINNER 160.00
Van from Sierra Bullones to Garcia-Hernandez 160.00
TOTAL 1,375.00

Purpose: TO ATTEND THE DIVISION SCHOOL PRESS CONFERENCE 2022

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above goods and services were acquired
from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.

Certified Correct: Noted by:

Signature

JOHN MC RAE D. RACINES MA. GINA G. HORNIDO


TEACHER II PRINCIPAL
Date 8/4/2022 Date 04/082022
DIVISION OF BOHOL
CERTIFICATE OF TRAVEL COMPLETED

APPENDIX B

ENTITY NAME: Department of Education-Division of Bohol FUND CLUSTER: 01 Regular

BIANITO A. DAGATAN EdD, CESO V Division of Bohol


Schools Division Superintendent Station

I HEREBY CERTIFY THAT I have completed the travel as authorized in the Travel Order/
Itinerary of Travel No. 22061669 dated June 24, 2022 under condition indicated below.

/X/ Strictly in accordance with the approved itinerary.


/ / Cut short as explaIned below, excess payment in the amount of ________________
was refunded under OR No. _________________ dated _______________________.
/ / Extended as explained below, additional itinerary was submitted.
/ / Other deviation as explained below.

EXPLAINATION OR JUSTIFICATIONS : ______________________________________


___________________________________________________________________________

Evidence of Travel:
/X/ Travel Order
/X/ Used Tickets
/X/ Certificate of Appearance / locator slip
/ / Other deviation as explain

Respectfully submitted:

JANNETH L. TUMANDA
Master Teacher I

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

Approved:

BIANITO A. DAGATAN EdD, CESO V


Schools Division Superintendent

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