Appendix 46

REIMBURSEMENT EXPENSE RECEIPT

Entity Name : DEPED SDO PASIG Fund Cluster : 01
CITY
RER No. : 1

RECEIVED from ___________________________________

(Name)
______________________________________________________
(Official Designation)
of _____________________________________________________
(In Words) (in Figures)
in payment _____________________________________________
(Payments for subsistence, services,
__________________________________________________________
rental or transportation should show inclusive dates,

____________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Office Signature
Address

WITNESS
Name/Signature:
Address:
 Appendix 46

REIMBURSEMENT EXPENSE RECEIPT

Entity Name : DEPED SDO PASIG Fund Cluster : 01
CITY
Date : RER No. : 4

RECEIVED from ___________________________________

(Name)
_______________________________________________________
(Official Designation)
of _____________________________________________________
(In Words) (in Figures)
in payment _______________________________________________
(Payments for subsistence, services,
__________________________________________________________
rental or transportation should show inclusive dates,

____________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Office Signature
Address

WITNESS
Name/Signature:
Address:
GENERAL FORM No. 2 GENERAL FORM No. 2
Revised January 1992 Revised January 1992
REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT
Date No. Date No.

Received from ______________________________________ Received from ______________________________________

(Name) (Name)

______________________________________ the amount of ______________________________________ the amount of

_______________________________ (P _______________) _______________________________ (P _______________)
(in words) (in figures) (in words) (in figures)

in payment for ______________________________________ in payment for ______________________________________

(Payment for subsistence, service, (Payment for subsistence, service,

__________________________________________________ __________________________________________________
rental or transportation should show inclusive dates, rental or transportation should show inclusive dates,

__________________________________________________ __________________________________________________
purpose, distance, inclusive points of travel, etc. purpose, distance, inclusive points of travel, etc.

PAYEE
Name/Signature _____________________________________
Address ___________________________________________
Comm. Tax Cert. No. ________________________________
Date Issued ________________________________________
Place Issued _______________________________________
PAYEE
Name/Signature _____________________________________
Address ___________________________________________
Comm. Tax Cert. No. ________________________________
Date Issued ________________________________________
Place Issued _______________________________________

WITNESS WITNESS

Name/Signature _____________________________________ Name/Signature _____________________________________

Address ___________________________________________ Address ___________________________________________
Comm. Tax Cert. No. _______________________________ Comm. Tax Cert. No. _______________________________

GENERAL FORM No. 2 GENERAL FORM No. 2

Revised January 1992 Revised January 1992
REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT
Date No. Date No.

Received from ______________________________________ Received from ______________________________________

(Name) (Name)

______________________________________ the amount of ______________________________________ the amount of

_______________________________ (P _______________) _______________________________ (P _______________)
(in words) (in figures) (in words) (in figures)

in payment for ______________________________________ in payment for ______________________________________

(Payment for subsistence, service, (Payment for subsistence, service,

__________________________________________________ __________________________________________________
rental or transportation should show inclusive dates, rental or transportation should show inclusive dates,

__________________________________________________ __________________________________________________
purpose, distance, inclusive points of travel, etc. purpose, distance, inclusive points of travel, etc.

PAYEE PAYEE
Name/Signature _____________________________________ Name/Signature _____________________________________
Address ___________________________________________ Address ___________________________________________
Comm. Tax Cert. No. ________________________________ Comm. Tax Cert. No. ________________________________
Date Issued ________________________________________ Date Issued ________________________________________
Place Issued _______________________________________ Place Issued _______________________________________

WITNESS WITNESS

Name/Signature _____________________________________ Name/Signature _____________________________________

Address ___________________________________________ Address ___________________________________________
Comm. Tax Cert. No. _______________________________ Comm. Tax Cert. No. _______________________________
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