VEHICLE REQUEST FORM

DATE: 9/4/2023
This is to request the use of DICT Vehicle for the following details:
DATE OF TRAVEL: Sept 7-8, 2023

TIME
NAME OF PASSENGER(S) DESTINATION PURPOSE
DEPARTURE ARRIVAL
Sheryl Mae Jerusalem

Engagement with LGU regarding the implementation of Free

Anini-y; Barbaza; San Remigio
Wi-Fi Project in Antique

*NOTE: This form should be submitted to the DICT Motorpool Section one (1) day before the REQUESTED DATE OF TRAVEL

REQUESTED BY: APPROVED BY: NAME OF DRIVER:

SHERWIN ROY E. FADUGA GYMEO Y. SOLLANO

Service Vehicle is Available

No Service Vehicle is Available ROMMEL A. BAYOT
DISPATCHER