RER

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GAAM Vol. II Appendix 18 GAAM Vol.

II Appendix 18
Reevised January 1992 Reevised January 1992

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT


Date No. Date No.

RECEIVED from ______________________________________ RECEIVED from ______________________________________


(Name) (Name)
_____________________________________________ the amount _____________________________________________ the amount
(Official Designation) (Official Designation)
of ________________________________________ (Php ______________) of ________________________________________ (Php ______________)

in payment for ________________________________________________ in payment for ________________________________________________


(Payments for subsistence, services, (Payments for subsistence, services,
_____________________________________________________________ _____________________________________________________________
rental or transportation should show inclusive dates, rental or transportation should show inclusive dates,
_____________________________________________________________ _____________________________________________________________
purpose, distance, inclusive points of travel, etc. purpose, distance, inclusive points of travel, etc.

PAYEE PAYEE
Name/Signature ______________________________________________ Name/Signature ______________________________________________
Address _____________________________________________________ Address _____________________________________________________

Residence Cert. No. ___________________________________________ Residence Cert. No. ___________________________________________


Date of Issue _________________________________________________ Date of Issue _________________________________________________
Place of Issue ________________________________________________ Place of Issue ________________________________________________

WITNESS WITNESS
Name/Signature ______________________________________________ Name/Signature ______________________________________________
Residence Cert. No. ___________________________________________ Residence Cert. No. ___________________________________________
Date of Issue _________________________________________________ Date of Issue _________________________________________________
Place of Issue ________________________________________________ Place of Issue ________________________________________________

DMP DMP

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