Republic of the Philippines

Court: Municipal Trial Court

11th Judicial Region
Station: 3 MCTC Nabunturan-Montevista-Mawab, Davao De Oro
rd

CERTIFICATE OF TRAVEL COMPLETED

I certify that I have completed the travel authorized in the Itinerary of Travel dated
AUGUST 19, 2022 under the condition(s) [marked with a “”] indicated below:

[ ] Strictly in accordance with the approved itinerary.

[ ] Cut short as explained below. Excess cash advance in the amount of

P .was refunded to the Clerk of Court/OIC (as evidenced by the
Acknowledgment Receipt issued on __________________.

[ ] Extended as explained below. Additional itinerary was submitted.

[ ] Other deviations as explained below.

Explanation or justification:

Evidence of travel (marked with a “”) attached hereto:

Fare Ticket (if applicable)

Return of Service
Others (specify)

Respectfully submitted.

ARIES DANIEL N. LUMANTAS

Sheriff/Process Server/Court-Authorized Person

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

PATRICK JUN C. FAJARDO II

Clerk of Court II
 Republic of the Philippine+s
Court: Municipal Trial Court
11th Judicial Region
Station: 3rd MCTC Nabunturan-Montevista-Mawab, Davao De Oro

Date:
STATEMENT OF LIQUIDATION AUGUST 26, 2022

For Case No.:518-22 For Voucher No.:

Title of Case: TAGUM COOP VS. NESA RHEA C. LABRADOR, For Official Receipt No.:
DAVIE E. BALUIS & MA. GEMMA T. MENCIDOR

PARTICULARS AMOUNT

TO LIQUIDATE the cash advance incurred in the service of

ORDER AND SUMMONS WITH COMPLAINT to certain with NESA P 130.00
RHEA C. LABRADOR, DAVIE E. BALUIS & MA. GEMMA T.

MENCIDOR residence address at Brgy. CABIDIANAN,

NABUNTURAN, DAVAO DE ORO issued under voucher number
above as per attached Certificate of Travel Completed.

TOTAL AMOUNT SPENT (Refer to the Itinerary of Travel for complete details of
actual expenses) P 130.00
LESS: AMOUNT OF CASH ADVANCE P 130.00
AMOUNT REFUNDED TO THE CLERK OF COURT/OIC P 0.00
AMOUNT TO BE REIMBURSED P 0.00
A Certified: B Recommending Approval: C Approved:
Correctness of the above data Supporting documents certified correct and
complete
ARIES DANIEL N. LUMANTAS LEAH GARNET G.
Process Server/ Court- PATRICK JUN C. FAJARDO II SOLDE-ANNOGUI
Authorized Person
Clerk of Court II Executive Judge/
Presiding Judge