Appendix 32

Republic of the Philippines Fund Cluster :

Department of Education SCHOOL MOOE
Region V
DIVISION OF MASBATE PROVINCE
Rodeo Road, Masbate City
Date
DV :
DISBURSEMENT VOUCHER No. :

Mode of
Payment MDS Check Commercial Check ADA Others (Please specify)

TIN/Employee No.: ORS/BURS No.:

Payee RUDYMAR S. SAQUILLO

Address STO. NINO, MALAKING ILOG, SAN PASCUAL, MASBATE

Particulars Responsibility Center MFO/PAP Amount

To: Payment ✘ Reimbursement of:
Travel Expenses incurred while on Official Business as per
supporting documentss hereto attached in the amount of
P 3,980.00

Amount Due P 3,980.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

RICHARD Y. MANGUBAT
Principal / School Head

B. Accounting Entry:
Account Title UACS Code Debit Credit

TRAVELLING EXPENSES 50201010-00 3,980.00

ADVANCES FOR OPERATING EXPENSES 19901010-00 3,980.00

C. Certified: D. Approved for Payment:

Cash available
Subject to Authority to Debit Account (when applicable)
Suppo
Signature Signature

Printed Name ALLAN A. DAGOHOY Printed Name RICHARD Y. MANGUBAT

Position Bookkeeper Position Principal / School Head
Date Date
E. Receipt of Payment JEV No.:
Date : Bank Name & Account Number:
Check/ ADA
No. :

Date : Printed Name: Date:

Signature :
RICHARD Y. MANGUBAT
Official Receipt No. & Date/Other Documents
REVISED ANNEX E

Republic of the Philippines

Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
SAN PASCUAL SOUTH DISTRICT

LOCATOR SLIP

NAME RICHARD Y. MANGUBAT

POSITION/DESIGNATION PRINCIPAL-II
PERMANENT STATION PATROCINIO DELA TORRE NHS
PURPOSE OF TRAVEL
(must be supported by
attachments)
PLEASE CHECK ✘ Official Business Official Time
DATE AND TIME
DESTINATION

Signature of Requesting Employee Signature of Head of Office

CERTIFICATION

To the concerned:

This is to certify that the above-named DepEd official/personnel has visited or

appeared at this Office/place for the purpose and during the date and time stated above.

Name and Signature:

Position/Designation:
Office:
 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
SAN PASCUAL SOUTH DISTRICT

No:

TRAVEL AUTHORITY FOR OFFICIAL TRAVEL

Name

Position / Designation

Permanent Station

Purpose of Travel (must be

supported by attachments)

Host of Activity

Inclusive of Travel Time

Destination

Fund Source

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 purpose stated herein.

Name and Signature of Recommending Authority Date:

APPROVED

Name and Signature of Approving Authority Date:

 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
San Pascual South District

PATROCINIO DELA TORRE NATIONAL HIGH SCHOOL

Name of School

NAME: RUDYMAR S. SAQUILLO Position: T-I

SALARY: 27,000.00 Station: PATROCINIO DELA TORRE NHS
PURPOSE OF ORIENTATION-WORKSHOP FOR THE SENIOR HIGH SCHOOL TEACHERS IN THE IMPLEMENTATION OF THE NLC
TRAVEL:

ITINERARY OF TRAVEL

TIME ALLOTMENT EXPENSES

Means of
DATE Place to be Visited Transportation TOTAL AMOUNT
Departure Arrival Fare Per Diem

4/30/2024 STATION TO SAN PASCUAL PORT 8:00 PM 10:00 PM HABALHABAL 500.00 500.00

5/1/2024 SAN PASCUAL TO AROROY 12:00 PM 6:00 AM RORO 900.00 900.00

AROROY - CATAINGAN 6:00 AM 8:00 AM VAN 550.00 550.00

5/1/2024 SEMINAR PROPER -

5/2/2024 SEMINAR PROPER -

5/3/2024 SEMINAR PROPER -

5/3/2024 CATAINGAN- MASBATE 6:00 PM 7:00 PM VAN 550.00 550.00

5/3/2024 MASBATE PORT- PIO DURAN 8:00 PM 12:00 PM RORO 280.00 280.00

5/4/2024 PIO DURAN-CLAVERIA 4:00 AM 6:00 AM PUMPBOAT 200.00 200.00

5/4/2024 CLAVERIA-SAN PASCUAL 6:00 AM 8:00 AM HABALHABAL 1,000.00 1,000.00

TOTAL 3,980.00 - 3,980.00

I hereby certify that:
(1) I have reviewed the foregoing itinerary;
(2) the travel is necessary to the service; RUDYMAR S. SAQUILLO
(3) the period covered is reasonable; and Official/Employee
(4) the expenses claimed are proper.

ALLAN DAGOHOY RICHARD Y. MANGUBAT

Bookkeeper-Designate PSDS/Principal/School Head
 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
SAN PASCUAL SOUTH DISTRICT

CERTIFICATE OF TRAVEL COMPLETED

Agency Head: RAYMUNDO M. CANTONJOS, CESO VI Station: PATROCINIO DELA TORRE NHS
Position: SCHOOLS DIVISION SUPERINTENDENT Date: 04/19/2024

I certify that I have completed the travel authorized in itinerary of Travel No.
dated, under conditions indicated below:

✘ Strictly in accordance with the approved itinerary.

Cut short as explained below. Excess payment in the amount of P
was refunded under Official Receipt No. dated
Extended as explained below, additional itinerary was submitted.

Other deviations as explained below.

Explanation or justification:

Evidence of travel:
Used tickets ✘ Certificate of Appearance ✘ Others

Respectfully submitted:

RICHARD Y. MANGUBAT
Official/Employee

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

MARICEL S. NEVERIO, Ph.D.

Immediate Supervisor
 REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF EDUCATION
REGION V
DIVISION OF MASBATE
SAN PASCUAL SOUTH DISTRICT

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001- dated June 19, 2017

Name of Employee Employee

No.
Office
Division MASBATE
Date Particulars Amount (₱)

TOTAL -
Purpose:

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:
Employee Immediate Supervisor
Date Date
 Appendix 46

REIMBURSEMENT EXPENSE RECEIPT

Entity Name: PATROCINIO DELA TORRE NHS Fund Cluster : MOOE

Date : 4/30/2024 RER No. :

RECEIVED from RUDYMAR S. SAQUILLO

(Name)
TEACHER-I the amount of
(Official Designation)
in payment for 500.00 )
FIVE HUNDRED PESOS ONLY (P
________________
(In Words)
________________ (in Figures)
_______________ travel expenses (habalhabal)
(Payments for subsistence, services,
05/04/2024 from Claveria to San Pascual station
rental or transportation should show inclusive dates,
05/04/2024 Attended NLC workshop-orientatiom
purpose, distance, inclusive points of travel, etc.)

PAYEE

Name/Signature: MARK FUENTES

Address: Claveria, Masbate

WITNESS

Name/Signature: VINCENT L. AGUELO

Address: MA\LAKING ILOG, SAN PASCUAL, MASBATE
 Republika ng Pilipinas
Kagawaran ng Edukasyon
Region V
DIVISION OF MASBATE PROVINCE
Rodeo Rd., Masbate City

ACKNOWLEDGEMENT RECEIPT

Date:

This is to acknowledege the receipt of the amount of THIRTEEN THOUSAND Pesos Only
(P 13,000.00 ) from RICHARD MANGUBAT (PDTNHS) as payment for the
MONTH OF MARCH(UTILITY) .

ARNOLD A. BUSMENTE
Signature Over Printed Name of Payee
Date:

HONEYLOU S. MENDOZA SHAYNE S. DAGOHOY

Signature Over Printed Name of Witness Signature Over Printed Name of Witness
Date: Date:
 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
San Pascual South District

HALABANGBAYBAY ELEMENTARY SCHOOL

Name of School

Purpose : Breakdown Expenses for the Contestant

TIME Means of Transportation

PLACES TO BE VISITED MEALS AMOUNT
DEPARTURE ARRIVAL transportation Exp. / Fee

Total - - -

Prepared By: Certified Correct:

RHEA B. DELA CRUZ CHERRY Y. CASTRO

School Property - Designate Bookkeeper - Designate

Approved:

ALEX B. CASTILLO
Principal/School Head
 Republic of the Philippines
Department of Education
Region V
Division of Masbate Province
Rodeo Rd., Masbate City
San Pascual South District

HALABANGBAYBAY ELEMENTARY SCHOOL

Name of School

PAYROLL for Transportation Expenses for

NAME AMOUNT RECEIVED GRADE LEVEL SIGNATURES

Total -

Prepared By: Certified Correct:

RHEA B. DELA CRUZ CHERRY Y. CASTRO

School Property - Designate Bookkeeper - Designate

Approved:
ALEX B. CASTILLO
Principal/School Head