Republic of the Philippines

Province of Camarines Sur

Municipality of Libmanan

CONTROL NO:
DATE:
DRIVER TRIP TICKET
To be filled up by the Administrative travel.

1. Name of Driver: JESSIE L. ALFONSO

2. Government Car to be used, PLATE No.: D2L384 / TRAVIZ
3. Name of authorized passenger:
4. Place of places to be visited/ inspected:
5. Purpose:

JESUS F. CAMARA
Chief/Head of Official of his duty
Authorized Representative

To be filled by driver:
1. Time of departure from the office/garage: a.m./p.m.
2. Time of arrival at (per no. 4 above): a.m./p.m.
3. Time of departure from (per no. 4) a.m./p.m.
4. Time of arrival back to office/garage: a.m./p.m.
5. Approved distance travelled (to & from): a.m./p.m.
6. Gasoline Issued, purchased and consumed:
a. Balance in tank : liters
b. Issued by Office from stock: liters
c. Add purchase during trip: liters
TOTAL: liters
d. Deduct: Used during the trip (to & from) liters
e. Balance in Tank at the end of the trip liters
7. Gear oil issued: liters
8. Lubricant oil issued: liters
9. Grease issued: liters
10. Speed meter reading if any:
At the beginning of trip: miles/kms
At the end of trip: miles/kms
Distance travelling (per 5 above): miles/kms
11. REMARKS:

I hereby certify to the correctness of the above statement of record to travel.

JESSIE L. ALFONSO
Driver
I hereby certify that I used this car on Official business as stated above.

Name of Passenger
 Republic of the Philippines
Province of Camarines Sur
Municipality of Libmanan

CONTROL NO:

VEHICLE TRIP TICKET

INSTRUCTION:
1. To be filled in duplicate by persons requesting the ministry vehicle.
2. Original copy for the driver, to be returned to the administration upon completion.
3. Duplicate copy to administration service for control.

TO BE FILLED UP ONLY BY PERSON REQUESTING FOR USER OF THE MINISTRY VEHICLE.

Vehicle Plate No. D2L384

Date:

DRIVER’S NAME: JESSIE L. ALFONSO

AUTHORIZED PASSENGERS:
DESTINATION:
PURPOSE:
AUTHORIZED BY:

JESUS F. CAMARA
Municipal Mayor

TO BE FILLED UP ONLY BY THE DRIVER AT THE END OF THE TRIP

INITIAL
TRIP NO.
READING
TIME PLACE TIME PLACE

GASOLINE USED:
Balance in tank: liters
Issued from the stock: liters
Purchase outside: liters
Gasoline used: liters
Balance in tank: liters
Gear oil: liters
Brake fluid: liters
Grease issued: liters
TOTAL DISTANCE: liters

JESSIE L. ALFONSO
Driver

I hereby certify that I used this car on official business as stated above.

Passenger
 Republic of the Philippines
Province of Camarines Sur
Municipality of Libmanan

CONTROL NO:
DATE:
DRIVER TRIP TICKET
To be filled up by the Administrative travel.

6. Name of Driver: ERIC A. BALIDOY

7. Government Car to be used, PLATE No.: TOYOTA HIACE - S2N944
8. Name of authorized passenger:
9. Place of places to be visited/ inspected:
10. Purpose:

JESUS F. CAMARA
Chief/Head of Official of his duty
Authorized Representative

To be filled by driver:
12. Time of departure from the office/garage: a.m./p.m.
13. Time of arrival at (per no. 4 above): a.m./p.m.
14. Time of departure from (per no. 4) a.m./p.m.
15. Time of arrival back to office/garage: a.m./p.m.
16. Approved distance travelled (to & from): a.m./p.m.
17. Gasoline Issued, purchased and consumed:
a. Balance in tank : liters
b. Issued by Office from stock: liters
c. Add purchase during trip: liters
TOTAL: liters
d. Deduct: Used during the trip (to & from) liters
e. Balance in Tank at the end of the trip liters
18. Gear oil issued: liters
19. Lubricant oil issued: liters
20. Grease issued: liters
21. Speed meter reading if any:
At the beginning of trip: miles/kms
At the end of trip: miles/kms
Distance travelling (per 5 above): miles/kms
22. REMARKS:

I hereby certify to the correctness of the above statement of record to travel.

ERIC A. BALIDOY
Driver

I hereby certify that I used this car on Official business as stated above.

Mayor JESUS F. CAMARA

Municipal Mayor
 Republic of the Philippines
Province of Camarines Sur
Municipality of Libmanan

CONTROL NO:

VEHICLE TRIP TICKET

INSTRUCTION:
4. To be filled in duplicate by persons requesting the ministry vehicle.
5. Original copy for the driver, to be returned to the administration upon completion.
6. Duplicate copy to administration service for control.

TO BE FILLED UP ONLY BY PERSON REQUESTING FOR USER OF THE MINISTRY VEHICLE.

Vehicle Plate No. S2N944

Date:

DRIVER’S NAME: ERIC A. BALIDOY

AUTHORIZED PASSENGERS:
DESTINATION:
PURPOSE:
AUTHORIZED BY:

JESUS F. CAMARA
Municipal Mayor

TO BE FILLED UP ONLY BY THE DRIVER AT THE END OF THE TRIP

INITIAL
TRIP NO.
READING
TIME PLACE TIME PLACE

GASOLINE USED:
Balance in tank: liters
Issued from the stock: liters
Purchase outside: liters
Gasoline used: liters
Balance in tank: liters
Gear oil: liters
Brake fluid: liters
Grease issued: liters
TOTAL DISTANCE: liters

ERIC A. BALIDOY
Driver

I hereby certify that I used this car on official business as stated above.

Mayor JESUS F. CAMARA

Municipal Mayor