Travel Feeding Reim

Revised January 1992
REIMBURSEMENT EXPENSE RECEIPT

don't forget the RER no.
Date: MARCH 11, 2024 No. 13
Received from ROGELIO M. LLORITO

(Name of School Head)
of BANGKAL ELEMENTARY SCHOOL the amount

(Name of School)
of TWO HUNDRED PESOS ONLY ₱ 200.00

(In Words) (In Figure)
Specify distance if
travel, rate if labor
MOTORCYCLE FARE FROM SAPIAN DISTRICT OFFICE TO BANGKAL ES AND VICE VERSA
(payments for subsistence, services, rental or transportation
MARCH 11, 2024

should show inclusive date, purpose, distance, inclusive points of travel)
etc. __________________________________________________________________
WITNESS PAYEE
Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

Address: MANINANG, SAPIAN, CAPIZ BILAO, SAPIAN, CAPIZ
fill-in contact no. of
Res.Cert./Contact No.: 29287736 9997612025 witness & payee(driver)
Date of Issue: 9/1/2024
Place of Issue: SAPIAN,CAPIZ



(Name of School)
of TWOHUNDRED PESOS ONLY ₱ 200.00

Specify distance if
MARCH 6, 2024
etc. __________________________________________________________________
WITNESS PAYEE




(Name of School)

Specify distance if
MARCH 4, 2024
etc. __________________________________________________________________
WITNESS PAYEE


Date: FEBRUARY 26, 2024 No. 10


(Name of School)

Specify distance if
FEBRUARY 26, 2024

etc. __________________________________________________________________
WITNESS PAYEE




(Name of School)

Specify distance if
FEBRUARY 21, 2024

etc. __________________________________________________________________
WITNESS PAYEE




(Name of School)

Specify distance if
FEBRUARY 19, 2024

etc. __________________________________________________________________
WITNESS PAYEE




(Name of School)

Specify distance if
FEBRUARY 12, 2024

etc. __________________________________________________________________
WITNESS PAYEE




(Name of School)

Specify distance if
FEBRUARY 7, 2024
etc. __________________________________________________________________
WITNESS PAYEE




(Name of School)

Specify distance if
FEBRUARY 5, 2024
etc. __________________________________________________________________
WITNESS PAYEE


Date: JANUARY 22, 2024 No. 4


(Name of School)

Specify distance if
JANUARY 22, 2024

etc. __________________________________________________________________
WITNESS PAYEE




(Name of School)

Specify distance if
JANUARY 15, 2024

etc. __________________________________________________________________
WITNESS PAYEE




(Name of School)

Specify distance if
JANUARY 10, 2024

etc. __________________________________________________________________
WITNESS PAYEE




(Name of School)

Specify distance if
JANUARY 08, 2024

etc. __________________________________________________________________
WITNESS PAYEE

APPENDIX A
No.
Date: March 12, 2024
ITINERARY OF TRAVEL
Name: ROGELIO M. LLORITO Position: PRINCIPAL I
Official Station: BANGKAL ELEMENTARY SCHOOL Monthly Salary:
Purpose of Travel: To pick up Nutritious Food Packs (NFP) from Sapian District office to Bangkal Elementary School.
Means of
Date Place to Visit Departure Arrival Transportation Fare Per Diems Total
01/08/2024 BANGKAL ES TO SAPIAN DISTRICT OFFI 6:00 AM 6:25 AM MOTORCYCLE 100.00 100.00
SAPIAN DISTRICT OFFICE TO BANGKAL 6:35 AM 7:00 AM MOTORCYCLE 100.00 100.00
immediate supervisor or h
-
Total 2,600.00
name of the person
(2) (1) I HEREBY CERTIFY THAT I have reviewed the (1) Prepared by:
who travelled
foregoing itinerary, (2) the travel is necessary to the service,
(3) the period covered is reasonable, (4) the expenses claimed ROGELIO M. LLORITO
are proper. School Head
(2) Approved by:
LUZ U. BANSON EdD, CESE MIGUEL MAC D. APOSIN EdD, CESO V

OIC, Office of the Asst. Schools Division Superintendent Schools Division Superintendent
APPENDIX B
DEPED, DIVISION OF CAPIZ Date: December 12, 2023
MIGUEL MAC D. APOSIN,EdD,CESO V Station:
Agency Head
I hereby certify that I have completed the travel authorized in the Itinerary of Travel No. _______ dated _____________________
under the conditions indicated below.
Strictly in accordance with the prepared itinerary.
Cut short explained below. Excess payment in the amount of ____________________
was refunded under O.R. No. _________________ dated _____________________
Extended as explained below. Additional itinerary was submitted.
Other deviations as explained below:
Attached supporting documents:

.
On Evidence and information of which I have knowledge, the travel was undertaken.
Respectfully submitted:
MIGUEL MAC D. APOSIN EdD, CESO V
Schools Division Superintendent ROGELIO M. LLORITO
School Head
name of the person

who travelled
rvisor or
ANNEX A
Department of Education
Region VI - Western Visayas
Schools Division of Capiz
Roxas City
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001- dated June 19, 2017
Name of Employee DIOSEP T. BALDESIMO Employee No. 6387733
Office AGKANINGAY PRIMARY SCHOOL
Division CAPIZ
Particulars Amount ((₱)
01/08/2024 AGKANINGAY PS TO SAPIAN DISTRICT OFFICE 100.00
SAPIAN DISTRICT OFFICE TO AGKANINGAY PS 100.00
TOTAL 2,600.00
Purpose
MOTORCYCLE FARE FROM SAPIAN DISTRICT OFFICE TO AGKANINGAY PRIMARY SCHOOL
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose that above goods and services were acquired from
parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable by law.
Certified Correct: Noted By:

Signature:
Printed Name: DIOSEP
SCHOOL T. HEAD
BALDESIMO
OR LUZ U. BANSON EdD,DS CESE
FOR SCHOOL HEAD
TEACHER
Employee SCHOOL
Immediate Supervisor HEAD FOR
TEACHER
Date 12/3/2024 Date
NOTE: KUNG ANG FARE PER TRIP IS 300.00 AND BELOW
PLEASE USE CERT. OF EXPENSE NOT REQUIRING RECEIPT

PER TRIP MAG UBRA SANG CERT. OF EXPENSE POINT TO POINT
AD

Date: NOV. 9, 2020 No.
Received from DON C. YUTO

of DOUBLE THE MONEY ELEM. SCHOOL the amount

(Name of School)
of FOUR HUNDRED PESOS ONLY ₱ 400.00

Specify distance if
TRICYCLE FARE FROM DOUBLE THE MONEY ES TO SAPIAN DISTRICT OFFICE
NOV.9, 2020
etc. __________________________________________________________________
WITNESS PAYEE
Name/Signature: MAGDALENA ESCOBAR RODEL JIMENEZ

Address: DAMAYAN, SAPIAN, CAPIZ DAMAYAN, SAPIAN, CAPIZ
Date of Issue:
Place of Issue:
APPENDIX A
No.
Date: December 3, 2020
ITINERARY OF TRAVEL
Name: DON C. YUTO Position: P-I
Official Station: DOUBLE THE MONEY ELEMENTARY SCHOOL Monthly Salary: 50,000.00
Purpose of Travel: To pick up milk feeding supplies from Sapian District office to Double the Money Elementary School.
Means of
Date Place to Visit Departure Arrival Transportation Fare Per Diems Total
9-Nov-20 DES TO SAPIAN DISTRICT OFFICE 5:00 AM 5:30 AM TRICYCLE 30.00 30.00
SAPIAN DISTRICT OFFICE TO DES 6:00 AM 6:30 AM TRICYCLE 30.00 30.00
22-Nov-20 DES TO SAPIAN DISTRICT OFFICE 6:00 AM 6:30 AM TRICYCLE 30.00 30.00
SAPIAN DISTRICT OFFICE TO DES 7:00 AM 7:30 AM TRICYCLE 30.00 30.00
-
-
-
-
-
-
-
Total 120.00
(2) (1) I HEREBY CERTIFY THAT I have reviewed the (1) Prepared by:
foregoing itinerary, (2) the travel is necessary to the service,
(3) the period covered is reasonable, (4) the expenses claimed DON C. YUTO
are proper. SCHOOLHEAD
(2) Approved by:
NICASIO S. FRIO SALVADOR O. OCHAVO, JR., EdD, CESO V

Supervisor/Immediate Supervisor Schools Division Superintindent
APPENDIX B
DEPED, DIVISION OF CAPIZ Date:
SALVADOR O. OCHAVO, JR. EdD, CESO V Station:
Agency Head
I hereby certify that I have completed the travel authorized in the Itinerary of Travel No. _______ dated _____________________
under the conditions indicated below.
Strictly in accordance with the prepared itinerary.
Cut short explained below. Excess payment in the amount of ____________________
was refunded under O.R. No. _________________ dated _____________________
Extended as explained below. Additional itinerary was submitted.
Other deviations as explained below:
Attached supporting documents:

.
On Evidence and information of which I have knowledge, the travel was undertaken.
Respectfully submitted:
SALVADOR O. OCHAVO, JR., EdD, CESO V
Schools Division Superintindent DON C. YUTO name of th
travelled
SCHOOLHEAD
ANNEX A
Department of Education
Region VI - Western Visayas
Schools Division of Capiz
Roxas City
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001- dated June 19, 2017
Employee
Name of Employee KAREN
No.
Office DOUBLE THE MONEY ELEMENTARY SCHOOL
Division CAPIZ
Particulars Amount ((₱)
11/20/2023 TRICYCLE FARE FROM SAPIAN DISTRICT OFFICE TO DOUBLE THE MONEY ELEMENTARY SCHOOL 30.00
11/20/2023 TRICYCLE FARE FROM SAPIAN DISTRICT OFFICE TO DOUBLE THE MONEY ELEMENTARY SCHOOL
TOTAL 30.00
Purpose
TRICYLE FARE FROM SAPIAN DISTRICT OFFICE TO DOUBLE THE MONEY ELEMENTARY SCHOOL.
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose that above goods and
services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is
punishable by law.
Certified Correct: Noted By:
Signature:
Printed Name: DON C. YUTO NICASIO S. FRIO
Employee Immediate Supervisor
Date 11/9/2020 Date
DS FO
SCHO
SCHOOL HEAD OR TEACH
TEACHER
PER TRIP MAG UBRA SANG CERT. OF EXPENSE POINT TO POINT
FROM SCHOOL TO DISTRICT OFFICE VICE VERSA
DS FOR SCHOOL HEAD

SCHOOL HEAD FOR
TEACHER

Travel Feeding Reim

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Travel Feeding Reim

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Revised January 1992

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWO HUNDRED PESOS ONLY ₱ 200.00

MARCH 11, 2024

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWOHUNDRED PESOS ONLY ₱ 200.00

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWO HUNDRED PESOS ONLY ₱ 200.00

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWO HUNDRED PESOS ONLY ₱ 200.00

FEBRUARY 26, 2024

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWO HUNDRED PESOS ONLY ₱ 200.00

FEBRUARY 21, 2024

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWO HUNDRED PESOS ONLY ₱ 200.00

FEBRUARY 19, 2024

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWO HUNDRED PESOS ONLY ₱ 200.00

FEBRUARY 12, 2024

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWO HUNDRED PESOS ONLY ₱ 200.00

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWO HUNDRED PESOS ONLY ₱ 200.00

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWO HUNDRED PESOS ONLY ₱ 200.00

JANUARY 22, 2024

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER

REIMBURSEMENT EXPENSE RECEIPT

Received from ROGELIO M. LLORITO

of BANGKAL ELEMENTARY SCHOOL the amount

of TWO HUNDRED PESOS ONLY ₱ 200.00

JANUARY 15, 2024

Name/Signature: EBIT A. VILLAS ARMAN ODQUIER