Appendix 11

OBLIGATION REQUEST AND STATUS Serial No. : _____________________

DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT - REGION I Date : _________________________
Entity Name Fund Cluster : ___________________

Payee NICOLETTE MAY O. AMON, et al.

Office

Address CITY OF SAN FERNANDO, LA UNION

Responsibility UACS Object

Particulars MFO/PAP Amount
Center Code

To reimburse travelling expenses incurred for 4,084.00

Nationwide Orientation on the BuB Grievance SR 2015-06-0660 5020101000
Redress System

Total 4,084.00
A. B.
Certified: Charges to appropriation/alloment are Certified: Allotment available and obligated
necessary, lawful and under my direct supervision;and for the purpose/adjustment necessary as
supporting documents valid, proper and legal indicated above

Signature
Signature :
:
Printed Name: RHODORA G. SORIANO Printed Name: MERCEDES C. LLANES
Position
OIC-LGMED Chief Position : AO V/Chief, Budget Section
:
Head, Requesting Office/Authorized Representative Head, Budget Division/Unit/Authorized
Representative
Date
___________________________________ Date : ____________________________
:

C. STATUS OF OBLIGATION
Reference Amount
Balance
ORS/JEV/Check/ Obligation Payable Payment Due and
Date Particulars Not Yet Due
ADA/TRA No. Demandable
(a) (b) (c) (a-b) (b-c)
 Appendix 32

DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT - REGION I Fund Cluster :

Entity Name
Date :
DISBURSEMENT VOUCHER DV No. :

Mode of
Payment MDS Check Commercial Check ADA Others (Please specify)
_________________
TIN/Employee No.: ORS/BURS No.:
Payee NICOLETTE MAY O. AMON, et al.

Address CITY OF SAN FERNANDO, LA UNION

Responsibility
Particulars MFO/PAP Amount
Center
To reimburse travelling expenses incurred for Nationwide SR 2015-06-0660 4,084.00
Orientation on the BuB Grievance Redress System

Amount Due 4,084.00

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

RHODORA G. SORIANO
OIC-LGMED Chief

B. Accounting Entry:
Account Title UACS Code Debit Credit
Consultancy Services
Due to BIR
Cash - MDS, Regular
C. Certified: D. Approved for Payment
Cash available

Subject to Authority to Debit Account (when applicable)

SuppSupporting documents complete and amount claimed

proper

Signature Signature

Printed Name Printed Name

SETY ZORAYDA S. PEREZ JULIE J. DAQUIOAG, Ph.D., CESO IV
Chief, Accounting Section Regional Director
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative

Date Date

E. Receipt of Payment JEV No.

Check/ ADA Date : Bank Name & Account Number:
No. :
Date : Printed Name: Date
Signature :

Official Receipt No. & Date/Other Documents

 Appendix 45

ITINERARY OF TRAVEL

Entity Name : DILG-RO1

Fund Cluster: ____________________ No.: _______________

Name : NICOLETTE MAY O. AMON, et al. Date of Travel : December 12-14, 2016
Position : LGOO IV Purpose of Travel : Nationwide Orientation the BuB Grievance
Official Station : LGMED Redress System

Places to be visited TIME Means of Transpor- Per Total

Date Others
(Destination) Departure Arrival Transportation station Diem Amount
OS to CSF Bus Terminal 8:00 AM 8:30 AM Tri 25.00 320.00 345.00
Dec. 11,
Bus Terminal to Dau 9:00 AM 1:00 PM Pvt 286.00 286.00
2016
Dau to Clark 1:00 PM 1:30 PM Hired Vehicle 150.00 150.00

Dec. 12 - Still in Clark 160.00 x 3 480.00

14, 2016

Clark to Dau 5:00 PM 5:30 PM Hired Vehicle 150.00 320.00 470.00

Nov. 18,
Dau to CSF Bus Terminal 5:30 PM 9:30 PM Pvt 286.00 286.00
2016
Bus Terminal to OS 9:30 PM 10:00 PM Tri 25.00 25.00
2,042.00
x2

TOTAL 4,084.00
Prepared by :

VILGLADYS M. MAGLAYA NICOLETTE MAY O. AMON

I certify that :
(1) I have reviewed the foregoing itinerary, MIS Staff, RPMT LGOO IV
(2) the travel is necessary to the service,
(3) the period covered is reasonable and Approved by:
(4) the expenses claimed are proper.

RHODORA G. SORIANO JULIE J. DAQUIOAG, Ph.D., CESO IV

OIC LGMED Chief Regional Director
Immediate Supervisor Agency Head/Authorized Representative
 Republic of the Philippines
DEPARTMENT OF THE INTERIOR AND LOCAL GOVERNMENT
Regional Office I
Aguila Rd., City of San Fernando, La Union
TRAVEL ORDER
No.
Date: September 14, 2023

Name: ALDRIN D. NOLASCO Position: SLGP DMO III

JANETH JOY H. PASCUAL SLGP DMO II

Official Station: DILG-ROI Salary/Mo.:

Departure Date: September 15, 2023 Return Date: September 16, 2023

EXPECTED DATES PURPOSES

Aloha Nui Hotel, Candon City

Ocular Inspection for the venue
September 15, 2023 of upcoming CapDev Program
Ban-aw Resort, Candon City, IS
for CSOs in LDC

Report to: Position: ___________________________

Per diems expenses allowed:
First/Second/Third Class transportation is hereby authorized.
Land/Air/Water transportation is hereby authorized.
Appropriation to travel expenses should be charged to________________________
Remarks or special instruction__________________________________________

Recommended by: Approved by:

RHODORA G. SORIANO JONATHAN PAUL M. LEUSEN, JR., CESO III

Name Name

LGMED Chief Regional Director

Position/Designation Position/Designation