SAMPLE OF ANNEX A NO.

2024 –02- 0021

YEAR- MONTH- CTRL NO.

-ONLY THE OSDS SECRETARY RELEASES
Republic of the Philippines THE CTRL NO. WHETHER I IS DIVISION

Department of Education MOOE, SCHOOL MOOE, AND LOCAL

FUNDS.
Region IX, Zamboanga Peninsula
DIVISION OF PAGADIAN CITY

TRAVEL AUTHORITY FOR OFFICIAL TRAVEL

NAME
Position/Designation
Permanent Station
Purpose of Travel
(must be supported by
attachments)
Host of Activity
Inclusive Dates
Destination (MOST ECONOMICAL AND EFFICIENT)

Fund Source (Subject to availability of funds and usual accounting and auditing
rules and regulations)
I hereby attest that the information in this form and in the supporting documents attached hereto are true and
correct.

Name and Signature of Requesting Employee Date

This is to certify that the trip of the requesting employee satisfies all the minimum conditions for authorized official
travel and that alternatives to travel are insufficient for the purpose stated herein.

JUDITH V. ROMAGUERA, EdD, CESO VI

Assistant Schools Division Superintendent
Name and Signature of Recommending Authority Date
APPROVED

LOURMA I. POCULAN, CESO VI

OIC - Schools Division Superintendent
Name and Signature of Approving Authority Date

Department of Education, Pagadian City Division, San Jose Heights, San Jose, Pagadian City
depedpagadian.org || facebook.com/pagadian.division || pagadian.city@deped.gov.ph
SAMPLE OF ANNEX A NO. 2024 –02- 0021

Republic of the Philippines

Department of Education
Region IX, Zamboanga Peninsula
DIVISION OF PAGADIAN CITY

TRAVEL AUTHORITY FOR OFFICIAL TRAVEL

NAME ROLAND P. MAALAM

Position/Designation ADA- II
Permanent Station DepEd Pagadian City Division
Purpose of Travel
(must be supported by To attend 20th National Dental Health Month
attachments)
Host of Activity Philippine Dental Association-Zamboanga del Sur Chapter

Inclusive Dates February 2,6,11,14,28, 2024 (Official Time)

2-Dumalinao, Zamboanga Del Sur
6- Bogo Integrated School, Brgy. Bogo, Pagadian City
11- San Jose Parish, Pagadian City
Destination
14- Tiguma, Pagadian City
28- DepEd Regional Office IX
(most economical and efficient)

Fund Source (Subject to availability of funds and usual accounting and auditing rules
and regulations)
I hereby attest that the information in this form and in the supporting documents attached hereto are true and
correct.

ROLAND P. MAALAM
Name and Signature of Requesting Employee Date
This is to certify that the trip of the requesting employee satisfies all the minimum conditions for authorized official
travel and that alternatives to travel are insufficient for the purpose stated herein.

JUDITH V. ROMAGUERA, EdD, CESO VI

Assistant Schools Division Superintendent
Name and Signature of Recommending Authority Date
APPROVED

LOURMA I. POCULAN, CESO VI

OIC,Schools Division Superintendent
Name and Signature of Approving Authority Date

Department of Education, Pagadian City Division, San Jose Heights, San Jose, Pagadian City
depedpagadian.org || facebook.com/pagadian.division || pagadian.city@deped.gov.ph