Appendix 45

ITINERARY OF TRAVEL
Entity Name : SAN AGUSTIN ELEMENTARY SCHOOL
Fund Cluster: No.: _______________

Name : ROSALINA S. MONTOYA Date of Travel : JUNE 28-30, 2022

Position : PRINCIPAL I Purpose of Travel : TO ATTEND 39TH PRINCIPALS TRAINING AND DEVT.
Official Station : PROGRAM CUM NATIONAL BOARD CONFERENCE

Places to be visited TIME Means of Transpor- Per

Date Others
(Destination) Departure Arrival Transportation station Diem Total Amount

6/27/2022 San Agustin ES to Sta. Ana Bayan 09:00 AM 09:10 AM Tricycle 80.00 80.00
Sta. Ana to San Fernando Bus Terminal 09:11 AM 09:30 AM Jeep 30.00 30.00
San Fernando Bus Terminal to Cubao 09:31 AM 10:05 AM Bus 190.00 190.00
Cubao to NAIA Terminal 3 10:06 AM 10:59 AM Taxi 300.00 300.00
NAIA Terminal 3 to Iloilo Airport (vice versa) 11:00 AM Airplane 2,762.52 2,762.52
Iloilo Airport to Hotel 02:45 PM 3:20 PM Taxi 250.00 250.00

06/28/2022 Hotel to Venue 7:15 AM 7:45 AM Taxi 250.00 250.00

Breakfast to Lunch 360.00 360.00
Accomodation 900.00 900.00
Incidental fee 360.00 360.00
Venue to Hotel 5:05 PM 5:40 PM Taxi 250.00 250.00
-
6/29/2022 -
Hotel to Venue 7:10 AM 7:45 AM Taxi 250.00 250.00
Accomodation 900.00 900.00
Incidental fee 360.00 360.00
Venue to Hotel 5:05 PM 5:50 PM Taxi 250.00 250.00
-
-
6/30/2022 -
Hotel to Venue 7:15 AM 7:50 AM Taxi 250.00 250.00
Accomodation - -
Incidental fee 360.00 360.00
Venue to Hotel 5:05 PM 5:40 PM Taxi 250.00 250.00
Hotel to Iloilo Airport 5:41 PM 6:20 PM Taxi 250.00 250.00
Dinner 180.00 180.00
NAIA Terminal 3 to Cubao 10:20 PM 11:05 PM Taxi 300.00 300.00
7/1/2022 Cubao to San Fernando Bus Terminal 11:06 PM 12:20 AM Bus 190.00 190.00
San Fernando Bus Terminal to Sta. Ana Bayan 12:21 AM 1:05 AM Jeep 30.00 30.00
Sta. Ana Bayan to San Agustin ES 1:06 AM 1:15 AM Tricycle 80.00 80.00

Registration Fee 5,500.00 5,500.00

-

TOTAL 11,462.52 540.00 2,880.00 14,882.52

Prepared by :
I certify that : (1) I have reviewed the foregoing itinerary, (2)
the travel is necessary to the service, (3) the period covered is ROSALINA S. MONTOYA
reasonable and (4) the expenses claimed are proper. Principal I
Approved by:

ARCELI S. LOPEZ, Ph.D. SHIRLEY B. ZIPAGAN, Ph.D. CESE

School Governance & Operations Division, Chief Assistant Schools Division Superintendent
 SEMINAR/TRAINING (REGISTRATION) ELEMENTARY
1 Disbursement Voucher 1 School Head/Payee
2 Photocopy of Check 1
3 Deped Order/ Memoranda, Invitation 1
For School Heads - School Div. Supt.
4 Travel Order 1
5 Itinerary of Travel 1 School Head / SGOD / ASDS
6 Certificate of Travel Completed (Appnendix B) 1 School Head / ASDS
7 Official Reciept (Registration Fee) 1
Original Copy of plane/boat/bus tickets, boarding
8 1
pass, terminal fee receipt
8.1 RER for Taxi/Grab
9 Certificate of Appearance(Original) 1
10 Certificate of Participation (Photocopy) 1
11 Booking Details
Official Reciept ( Air Fare, Accomodation, Terminal
12 Fee)

SEMINAR/TRAINING (REGISTRATION) ELEMENTARY

1 Disbursement Voucher 1 School Head/Payee
2 Photocopy of Check 1
3 Deped Order/ Memoranda, Invitation 1
For School Heads - School Div. Supt.
4 Travel Order 1
5 Itinerary of Travel 1 School Head / SGOD / ASDS
6 Certificate of Travel Completed (Appnendix B) 1 School Head / ASDS
7 Official Reciept (Registration Fee) 1
Original Copy of plane/boat/bus tickets, boarding
8 1
pass, terminal fee receipt
8.1 RER for Taxi/Grab
9 Certificate of Appearance(Original) 1
10 Certificate of Participation (Photocopy) 1
11 Booking Details
Official Reciept ( Air Fare, Accomodation, Terminal
12 Fee)
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (tricycle ) Sto. Rosario ES going to Sta. Ana Bayan for PESPA Seminar at
Iloilo City June 27, 2022 100.00

Total 100.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (tricycle ) Sto. Rosario ES going to Sta. Ana Bayan for PESPA Seminar at
Iloilo City June 27, 2022 100.00

Total 100.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (jeepney ) Sta. Ana Bayan going to Sn FDO Termina for PESPA Seminar at
Iloilo City June 27, 2022 30.00

Total 30.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (BUS ) going to Cubao Termina for PESPA Seminar at
Iloilo City June 27, 2022 190.00

Total 190.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (Taxi ) going to NAIA for PESPA Seminar at
Iloilo City June 27, 2022 300.00

Total 300.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 REPUBLIC OF THE PHILIPPINES Fund Cluster :
DEPARTMENT OF EDUCATION
SCHOOL NAME
High School Blvd., Brgy. Lourdes, City of San Fernando (P)
Date :
DISBURSEMENT VOUCHER DV No. :

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

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee School Head

Address

Responsibility
Particulars MFO/PAP Amount
Center

To record payment of :
Registration Fee
Transportation (Itinerary of Travel)

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

Name of School Head

Position
B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment

ü Cash available
ü Subject to Authority to Debit Account (when applicable)
ü Supp
proper

Signature Signature

Printed
Printed Name
Name Name of School Head Name of School Head

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

Date Date

E. Receipt of Payment JEV No.

Check/ Date : Bank Name & Account Number:
ADA No. :
Signature : Date : Printed Name: Date

Official Receipt No. & Date/Other Documents

 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (Taxi )IloIlo Airport going to Hotel for PESPA Seminar at
Iloilo City June 27, 2022 250.00

Total 250.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (Taxi ) Hotel going to ICON for PESPA Seminar at
Iloilo City June 28, 2022 250.00

Total 250.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (Taxi ) ICON going to Hotel for PESPA Seminar at
Iloilo City June 28, 2022 250.00

Total 250.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (Taxi ) ICON going to Hotel for PESPA Seminar at
Iloilo City June 29, 2022 250.00

Total 250.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (Taxi ) Hotel going to ICON for PESPA Seminar at
Iloilo City June 29, 2022 250.00

Total 250.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (Taxi ) ICON going to Hotel for PESPA Seminar at
Iloilo City June 30, 2022 250.00

Total 250.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (Taxi ) Hotel going to IoIlo Airport for PESPA Seminar at
Iloilo City June 30, 2022 250.00

Total 250.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (Taxi ) NAIA going to Cubao Terminal for PESPA Seminar at
Iloilo City June 30, 2022 300.00

Total 300.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (bus ) Cubao Terminal going to San Fdo for PESPA Seminar at
Iloilo City June 30, 2022 190.00

Total 190.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (jeep) San Fernando Terminal going to Sta. Ana for PESPA Seminar at
Iloilo City June 30, 2022 30.00

Total 30.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS
 Department of Education

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017.

Name of Employee Employee No.

Office STO. ROSARIO ELEMENTARY SCHOOL

Division Division of Pampanga
Particulars Amount(P)
Transpo Expense (Tricycle ) Sta. Ana Bayan going to Sto. Rosario ES for PESPA Seminar at
Iloilo City June 30, 2022 100.00

Total 100.00
Purpose

Attend PESPA Seminar at Iloilo City from June 28 - 30, 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 acfrom parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punished by law.

Certified correct: Noted by:

Signature

Printed name REZZIE R. DUE EDNA L. PINEDA

Head Teacher I PSDS