Republic of the Philippines

Department of Education
Region IV-A
SCHOOLS DIVISION OF QUEZON PROVINCE
DISTRICT: ________________ SCHOOL: _______________________________________ DATE: _____________

Please be informed that the following documentary requirements are arranged and attached accordingly for the
claim of TRANSPORTATION AND DELIVERY EXPENSE (HAULING) included in the Liquidation Report for the month of
____________, _______ submitted to the Accounting Section of the Division Office.
(Month) (Year)

 Disbursement Voucher
 Photocopy of Check Issued
 Official Receipt (if applicable)
 Bus/Water Vessel Ticket/ Reimbursement Expense Receipt (RER)
 Photocopy of CTC or Driver’s License
 Picture of actual loading or unloading of materials

Certified by:

DEPEDQUEZON-TM-SDS-04-025-003

“Creating Possibilities, Inspiring Innovations”

Address: Sitio Fori, Brgy. Talipan, Pagbilao, Quezon
Trunkline #: (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321
Email Address:quezon@deped.gov.ph
Website: www.depedquezon.com.ph

--------------------------------------------------------------------------------------------------------------------------------------------------------------
(To be accomplished by accounting personnel)

DISTRICT: ______________________SCHOOL: ____________________________________________________PERIOD COVERED: _____________________

Sir/Ma’am:

Based on the submitted documents for the claim, the following are the findings which shall complied before the deadline to be liquidated:

 Please arrange/attached the forms properly based on the checklist

 Please attach copy of check issued.
 DISBURSEMENT VOUCHER
 Incomplete fill out: date/s; series number; name; check number  Wrong Accounting Entry
 No Signature on BOX A / BOX B  Miscomputation
 Others: ___________________________________________________________________________________________________________________
 OFFICIAL RECEIPT:
 Attach original copy  No date  No Signature
 Others: ___________________________________________________________________________________________________________________
 REIMBURSEMENT EXPENSE RECEIPT
 Incomplete fill out: date/s; series number; name
 Incomplete/No signature/s
 More than P1,000
 Others: ___________________________________________________________________________________________________________________
 COMMUNITY TAX CERTIFICATE/DRIVER’S LICENSE:
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
 PICTURE OF LOADING AND UNLOADING OF MATERIALS:
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
 OTHERS:______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
THANK YOU.
 Republic of the Philippines
Department of Education
Region IV-A
SCHOOLS DIVISION OF QUEZON PROVINCE
____________________________________
Signature over printed name of School Head

DEPEDQUEZON-TM-SDS-04-025-003

“Creating Possibilities, Inspiring Innovations”

Address: Sitio Fori, Brgy. Talipan, Pagbilao, Quezon
Trunkline #: (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321
Email Address:quezon@deped.gov.ph
Website: www.depedquezon.com.ph

--------------------------------------------------------------------------------------------------------------------------------------------------------------
(To be accomplished by accounting personnel)

DISTRICT: ______________________SCHOOL: ____________________________________________________PERIOD COVERED: _____________________

Sir/Ma’am:

Based on the submitted documents for the claim, the following are the findings which shall complied before the deadline to be liquidated:

 Please arrange/attached the forms properly based on the checklist

 Please attach copy of check issued.
 DISBURSEMENT VOUCHER
 Incomplete fill out: date/s; series number; name; check number  Wrong Accounting Entry
 No Signature on BOX A / BOX B  Miscomputation
 Others: ___________________________________________________________________________________________________________________
 OFFICIAL RECEIPT:
 Attach original copy  No date  No Signature
 Others: ___________________________________________________________________________________________________________________
 REIMBURSEMENT EXPENSE RECEIPT
 Incomplete fill out: date/s; series number; name
 Incomplete/No signature/s
 More than P1,000
 Others: ___________________________________________________________________________________________________________________
 COMMUNITY TAX CERTIFICATE/DRIVER’S LICENSE:
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
 PICTURE OF LOADING AND UNLOADING OF MATERIALS:
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
 OTHERS:______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
THANK YOU.