ALS-GSD-GSS-005

Rev. 1/Jul-03-17

TT-2020-00074
Republic of the Philippines
Department of Science and Technology
DOST Compound, General Santos Avenue, Bicutan, Taguig City 1631

VEHICLE TRIP TICKET

Instructions:
1. Driver shall fill this form in duplicate copy.
2. Driver shall keep the original copy for personal file.
3. Driver shall submit the duplicate copy to the Administrative and Legal Service / Motor Pool Unit for file control.

Date/s: February 3, 2020 Driver: NORMAN ONARO Plate No.: SJA 642

Authorized Passenger(s): VERNADETH CAHIBAYBAYAN

Destinations: DOST-CAINTA-DOST

Purpose(s): BUYING CULVERT AT CAINTA, RIZAL

Authorized by:

JHOVEN G. LITANA
OIC, GSD

INITIAL ODOMETER READING : KMS.

TRIP DEPARTURE TIME ARRIVAL TIME ODOMETER

NO. PLACE PLACE READING

*** TO BE FILLED ONLY BY THE DRIVER AFTER THE END OF THE TRIP ***

I hereby certify to the correctness of

the above statement of record of travel.

NORMAN ONARO
Driver

I/We hereby certify that I/We used this

vehicle on Official Business as stated above.

VERNADETH CAHIBAYBAYAN
Passenger/s