Travel Order - Ocular Inspection

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No.

NAME LBP ACCOUNT NUMBER POSITION


1 ERVIN I. GALLARDO LBP-0886-1081-76 Planning Officer III
2 MARQUIN M. DEFEO LBP-0885-0137-91 Planning Officer III
3 MARQUIN M. DEFEO LBP-0885-0137-91 Planning Officer III
4 MARQUIN M. DEFEO LBP-0885-0137-91 Planning Officer III
5 SHALEE Y. TADEJA SEPS - SMME
6 VICTOR F. CAUSAPIN Education Program Supervisor
7 JULIENETTE A. LORICA PDO I
8 VICTOR F. CAUSAPIN Education Program Supervisor
9 MARQUIN M. DEFEO LBP-0885-0137-91 Planning Officer III
10 MARQUIN M. DEFEO LBP-0885-0137-91 Planning Officer III
11 MARQUIN M. DEFEO LBP-0885-0137-91 Planning Officer III
12 ERIC C. TANECA LBP 0885-0127-52 Engineer III
13 MARQUIN M. DEFEO LBP-0885-0137-91 Planning Officer III
14 ERIC C. TANECA LBP 0885-0127-52 Engineer III
15 MARQUIN M. DEFEO LBP-0885-0137-91 Planning Officer III
16 ERVIN I. GALLARDO LBP-0886-1081-76 Senior Education Program Special
17 SHALEE Y. TADEJA LBP-0885-0004-10 SEPS - SMME
18 CHERRY ANN B. AMPER LBP-0885-0265-08 Administrative Aide VI
TIN PURPOSE HOST OF ACTIVITY
295-550-171-000 Data Management and Information Requirem DepEd Central Office - Pl
295-550-171-000 Program Profiling cum Target Setting 2023 Deped Regional Office -
295-550-171-000 2022 National Planning Conference (NPC) DepEd Central Office - Pl
295-550-171-000 School Improvement Plan Appraisal SDO Occidental Mindoro
School Improvement Plan Appraisal SDO Occidental Mindoro
School Improvement Plan Appraisal SDO Occidental Mindoro
School Improvement Plan Appraisal SDO Occidental Mindoro
National Refresher Courses for DepEd CoacDeped Regional Office
295-550-171-000 Regional Project Implementation Review Deped Regional Office -
295-550-171-000 DEDP Presentation to Regional Office Deped Regional Office -
295-550-171-000 Conduct of National Planning Conference oDepEd Central Office - E
271-695-748-000 Conduct of National Planning Conference oDepEd Central Office - E
295-550-171-000 Occidental Mindoro Strategic Planning FY House of Representative -
271-695-748-000 To attend the Seminar on the Technical AssDepEd Regional Office
295-550-171-000 Re-Orientation on DO 40, s. 2014 and RegioDeped Regional Office
415-530-096 To conduct the Private Schools Ocular InspDepEd, Division of Occide
To monitor the Opening of Classes for SY SDO Occidental Mindoro
to attend the Third Division Management SDO Occidental Mindoro
INCLUSIVE DATES DESTINATION FUND SOURCE AMOUNT STATUS DATE
November 8-11, 2022 Ace Hotel and Suites
October 24-28, 2022 Ace Hotel and Suites, Pasig City
November 14-18, 2022 Subic Bay Exhibition and Convention Center, Olongapo, Zambales
December 5-7, 2022 Mamburao District
December 6-8, 2022 Calintaan District
December 6-10, 2022 Rizal District
December 5-7, 2022 Mamburao District
December 17-22, 2022 Teachers Camp, Baguio City
January 3-7 Madison 101 + Tower, New Manila, Quez 6,860.00 CLAIMED 15-Mar
January 18-20 Madison 101 + Tower, New Manila, Quez 7,300.00 CLAIMED
February 5-11, 2023 Subic Bay Exhibition and Convention Ce 5,256.00 CLAIMED
February 5-11, 2023 Subic Bay Exhibition and Convention Center, Olongapo, Zambales
February 26-28, 2023 Dusit Thani Hotel, Makati, Metro Manila 7,300.00
September 13-15, 2023 NEAP-R MIMAROPA, Puerto Galera, Orie 7,300.00
March 5-9, 2023 Red Hotel, Cubao 11,300.00
March 19-22, 2024 Private Schools in the SDO 7,300.00 25-Aug-23
August 28 - September 1 See attached list of schools to be monito 3,740.00 25-Aug-23
June 30, 2023 San Jose Pilot Elementary School, San J 3,740.00
LOIDASDS
P. ADORNADO, PhD, CESO VI
Republic of the Philippines
Department of Education
MIMAROPA REGION
SCHOOLS DIVISION OF OCCIDENTAL MINDORO

TRAVEL AUTHORITY FOR OFFICIAL TRAVEL


NAME ERVIN I. GALLARDO
Position/Designation Senior Education Program Specialist
Permanent Station DepEd, Division of Occidental Mindoro
Purpose of Travel
(must be supported by
attachments) To conduct the Private Schools Ocular Inspection
Host of Activity DepEd, Division of Occidental Mindoro
Inclusive Dates March 19-22, 2024
Destination Private Schools in the SDO
Fund Source
I hereby attest that the information in this form and in the supporting documents attached hereto
are true and correct.

ERVIN I. GALLARDO _______________________


Senior Education Program Specialist 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.

RODEL S. MAGNAYE _______________________


Chief Education Supervisor Date
OIC, Assistant Schools Division Superintendent

Approved:

LOIDA P. ADORNADO, PhD, CESO VI _______________________


Assistant Schools Division Superintendent Date
Officer-in-Charge
Office of the Schools Division Superintendent
Appendix 45

ITINERARY OF TRAVEL
Entity Name: DEPED DIVISION OFFICE No:
Fund Cluster:

Name: ERVIN I. GALLARDO Date of Travel : March 19-22, 2024


Position: Senior Education Program Specialist Purpose of Travel:
To conduct the Private Schools Ocular Inspection
Official Station: DepEd, Division of Occidental Mindoro
TIME
Means of
Date Places to be visited (Destination) Per Diem Total
Departure Arrival Transportation
Transpor tation Fee

June 29, 2023 To Van terminal 6:00 AM 6:15 AM Tricycle 20.00 1,100.00 1,120.00
To Sta Cruz NHS 6:30 AM 8:00 AM Van 150.00 150.00
To Sablayan Van Terminal 8:10 AM 9:40 AM Van 150.00 150.00
To Sablayan NCHS 9:45 AM 9:55 AM Tricycle 20.00 20.00
To Sablayan Van Terminal 1:20 PM 1:30 PM Tricycle 20.00 20.00
To Mamburao Van Terminal 2:00 PM 5:00 PM Van 200.00 200.00
To Residence 5:00 AM 5:15 AM Tricycle 20.00 20.00

1,680.00
Prepared by:
I certify that: (1) I have reviewed the foregoing itinerary, (2)
the travel is necessary the to service, (3) the period covered is
reasonable and (4) the expenses claimed are proper. ERVIN I. GALLARDO
Senior Education Program Specialist

Approved by:

RODEL S. MAGNAYE LOIDA P. ADORNADO, PhD, CESO VI


Officer in Charge Assistant Schools Division Superintendent
Office of the Assistant Schools Division Superintendent OIC, Office of the Schools Division Superintendent
Appendix 45

ITINERARY OF TRAVEL
Entity Name: DEPED DIVISION OFFICE No:
Fund Cluster:

Name: ERVIN I. GALLARDO Date of Travel : March 19-22, 2024


Position: Senior Education Program Specialist Purpose of Travel:
To conduct the Private Schools Ocular Inspection
Official Station: DepEd, Division of Occidental Mindoro
TIME
Means of
Date Places to be visited (Destination) Per Diem Total
Departure Arrival Transportation
Transpor tation Fee

July 19, 2022 To Van terminal 7:00 AM 7:30 AM Tricycle 900.00 2,200.00 3,100.00
To Wawa, Abra De Ilog 7:30 AM 9:00 AM Van 500.00 500.00
To Puerto Galera Pier 10:00 AM 12:00 PM Boat 100.00 100.00
To RELC 12:01 PM 12:30 PM Tricycle 100.00 440.00 540.00

July 20-21, 2022 Training Proper 0.00

July 22, 2022 To Puerto Galera Pier 12:01 PM 12:30 PM Tricycle 100.00 660.00 760.00
Terminal Fee 500.00 500.00
To Batangas Pier 1:00 PM 3:00 PM Boat 900.00 900.00
Terminal Fee 0.00
To Abra de Ilog Pier 4:00 PM 7:00 PM Boat 0.00
To Mamburao 7:30 PM 8:30 PM Van 0.00
To residence 8:40 PM 9:00 PM Tricycle 0.00

6,400.00
Prepared by:
I certify that: (1) I have reviewed the foregoing itinerary, (2)
the travel is necessary the to service, (3) the period covered is
reasonable and (4) the expenses claimed are proper. ERVIN I. GALLARDO
Senior Education Program Specialist

Approved by:

ANICETO N. PAROJINOG LOIDA P. ADORNADO, PhD, CESO VI


Chief Education Supervisor, SGOD Assistant Schools Division Superintendent
OIC, Office of the Schools Division Superintendent
Appendix 45

ITINERARY OF TRAVEL
Entity Name: DEPED DIVISION OFFICE No:
Fund Cluster:

Name: ERVIN I. GALLARDO Date of Travel : March 19-22, 2024


Position: Senior Education Program Specialist Purpose of Travel:
To conduct the Private Schools Ocular Inspection
Official Station: DepEd, Division of Occidental Mindoro
TIME
Means of
Date Places to be visited (Destination) Per Diem Total
Departure Arrival Transportation
Transpor tation Fee

October 22, 2023 Mamburao-Manila 9:00 AM 5:00 PM Van door to door 1,800.00 2,200.00 4,000.00

October 23, 2023 Temporary residence-venue 12:30 PM 1:00 PM Taxi 440.00 440.00

October 23-27, 20 Training Proper

October 27, 2023 Manila-Mamburao 2:00 PM 10:00 PM Van door to door 1,800.00 660.00 2,460.00

6,900.00
Prepared by:
I certify that: (1) I have reviewed the foregoing itinerary, (2)
the travel is necessary the to service, (3) the period covered is
reasonable and (4) the expenses claimed are proper. ERVIN I. GALLARDO
Senior Education Program Specialist

Approved by:

ANICETO N. PAROJINOG LOIDA P. ADORNADO, PhD, CESO VI


Chief Education Supervisor, SGOD Assistant Schools Division Superintendent
OIC, Office of the Schools Division Superintendent
Appendix 45

ITINERARY OF TRAVEL
Entity Name: DEPED DIVISION OFFICE No:
Fund Cluster:

Name: ERVIN I. GALLARDO Date of Travel : March 19-22, 2024

Position: Senior Education Program Specialist


Official Station: DepEd, Division of Occidental Mindoro
To conduct the Private Schools Ocular
Purpose of Travel:
Inspection

TIME Means of
Date Places to be visited (Destination) Transpor Per Diem Total
Departure Arrival Transportation tation Fee
March 19, 2024 SDO to Lamont Adventist 6:00 AM 8:00 AM DepEd Pick up 1,200.00 1,200.00
Lamont Adventist to Seventh-Day 9:30 AM 10:30 AM DepEd Pick up
Seventh-Day to Treasures from t 11:30 AM 11:45 AM DepEd Pick up
TLDC to University of Perpetual 1:16 PM 2:00 PM DepEd Pick up
Perpetual Help Mission School t 3:30 PM 4:00 PM DepEd Pick up 0.00
San Rafael HS to DepEd SDO 5:00 PM 6:00 PM DepEd Pick up
March 20, 2024 SDO to WEMA DepEd Pick up 1,200.00 1,200.00
WEMA to Early Skills Learning Center DepEd Pick up
Early Skills Learning Center to HOSEA Mamburao DepEd Pick up
HOSEA Mamburao to HOSEA Santa Cruz DepEd Pick up
HOSEA Santa Cruz to Sievers Technological Institute DepEd Pick up
Sievers Technological Institute
DepEd Pick up
to DepED SDO
March 21, 2024 Stayed in SDO to answer
queries regarding NAT
March 22, 2024 SDO to WEMA DepEd Pick up 1,200.00 1,200.00
WEMA to Early Skills Learning Center DepEd Pick up
Early Skills Learning Center to HOSEA Mamburao DepEd Pick up
HOSEA Mamburao to HOSEA Santa Cruz DepEd Pick up
HOSEA Santa Cruz to Sievers Technological Institute DepEd Pick up
Sievers Technological Institute
DepEd Pick up
to DepED SDO

3,600.00
Prepared by:
I certify that: (1) I have reviewed the foregoing itinerary, (2) the travel
is necessary the to service, (3) the period covered is reasonable and ERVIN I. GALLARDO
(4) the expenses claimed are proper. Senior Education Program Specialist

Approved by:

ELIZABETH T. DELAS ALAS, PhD LOIDA P. ADORNADO, PhD, CESO VI


Chief Education Supervisor Assistant Schools Division Superintendent
School Governance and Operations Division Officer-In-Charge
Office of the Schools Division Superintendent
Appendix 45

ITINERARY OF TRAVEL
Entity Name: DEPED DIVISION OFFICE No:
Fund Cluster:

Name: ERVIN I. GALLARDO Date of Travel : March 19-22, 2024


Position: Senior Education Program Specialist Purpose of Travel:
To conduct the Private Schools Ocular Inspection
Official Station: DepEd, Division of Occidental Mindoro
TIME
Means of
Date Places to be visited (Destination) Per Diem Total
Departure Arrival Transportation
Transpor tation Fee

October 22, 2023 Mamburao-Manila 9:00 AM 5:00 PM Van door to door 1,800.00 2,200.00 4,000.00

October 23, 2023 Temporary residence-venue 12:30 PM 1:00 PM Taxi 440.00 440.00

October 23-27, 20 Training Proper

October 27, 2023 Manila-Mamburao 2:00 PM 10:00 PM Van door to door 1,800.00 660.00 2,460.00

6,900.00
Prepared by:
I certify that: (1) I have reviewed the foregoing itinerary, (2)
the travel is necessary the to service, (3) the period covered is
reasonable and (4) the expenses claimed are proper. ERVIN I. GALLARDO
Senior Education Program Specialist

Approved by:

ANICETO N. PAROJINOG LOIDA P. ADORNADO, PhD, CESO VI


Chief Education Supervisor, SGOD Assistant Schools Division Superintendent
OIC, Office of the Schools Division Superintendent
Appendix 45

ITINERARY OF TRAVEL
Entity Name: DEPED DIVISION OFFICE No:
Fund Cluster:

Name: ERVIN I. GALLARDO Date of Travel : March 19-22, 2024


Position: Senior Education Program Specialist Purpose of Travel: To conduct the Private Schools Ocular Inspection
Official Station: DepEd, Division of Occidental Mindoro
TIME
Means of
Date Places to be visited (Destination) Per Diem Total
Departure Arrival Transportation
Transpor tation Fee

3/5/2023 To Abra de Ilog 11:00 PM 11:45 PM Van 2,200.00 2,200.00


To Batangas 3:30 AM 6:30 AM Boat
To Manila 6:30 AM 11:30 AM Van 2,000.00 2,000.00

3/6-8/2023 Training Proper

3/9/2023 To Batangas 11:00 PM 2:00AM Van


To Abra de Ilog 3:30 AM 6:30 AM Boat
To Mamburao 6:30 AM 7:15 AM Van 2,000.00 1,100.00 3,100.00

Registration Fee
OR No. 6884694 K 4,000.00

11,300.00
Prepared by:
I certify that: (1) I have reviewed the foregoing itinerary, (2)
the travel is necessary the to service, (3) the period covered is
reasonable and (4) the expenses claimed are proper. ERVIN I. GALLARDO
Senior Education Program Specialist

Approved by:

ANICETO N. PAROJINOG LOIDA P. ADORNADO, PhD, CESO VI


Chief Education Supervisor, SGOD Assistant Schools Division Superintendent
OIC, Office of the Schools Division Superintendent
Appendix 45

ITINERARY OF TRAVEL
Entity Name: DEPED DIVISION OFFICE No:
Fund Cluster:

Name: ERVIN I. GALLARDO Date of Travel : March 19-22, 2024


Position: Senior Education Program Specialist Purpose of Travel:
To conduct the Private Schools Ocular Inspection
Official Station: DepEd, Division of Occidental Mindoro
TIME
Means of
Date Places to be visited (Destination) Per Diem Total
Departure Arrival Transportation
Transpor tation Fee

2/6/2023 To Abra de Ilog 9:00 AM 10:00 AM DepEd Van 1,500.00 1,500.00


To Batangas 1:00 AM 3:30 AM Boat 458.00 458.00
Terminal Fee 3:30 AM 8:00 AM 10.00 10.00
To Manila 3:30 AM 8:00 AM DepEd Van
To Olongapo 1:00 PM 5:00 PM DepEd Van
To Travelers Hotel 5:10 PM 5:20 PM DepEd Van

2/7 - 2/10, 2023 Conference Proper

2/11/2023 To Bus Terminal 12:00 PM 12:20 PM Taxi 150.00 750.00 900.00


To Manila 2:00 PM 7:00 PM Bus 388.00 388.00
To Mamburao 7:00 PM 2:00 AM Van 2,000.00 2,000.00

5,256.00
Prepared by:
I certify that: (1) I have reviewed the foregoing itinerary, (2)
the travel is necessary the to service, (3) the period covered is
reasonable and (4) the expenses claimed are proper. ERVIN I. GALLARDO
Senior Education Program Specialist

Approved by:

ANICETO N. PAROJINOG LOIDA P. ADORNADO, PhD, CESO VI


Chief Education Supervisor, SGOD Assistant Schools Division Superintendent
OIC, Office of the Schools Division Superintendent
Appendix 47

CERTIFICATION OF TRAVEL COMPLETED

Entity Name: DEPED DIVISION OFFICE Fund Cluster:

LOIDA P. ADORNADO, PhD, CESO VI DepEd SDO-Mamburao, Occidental Mindoro


Officer-in-Charge Station

I HEREBY CERTIFY THAT I have completed the travel as authorized in the Travel Order/Itinerary of
Travel No.____________________ dated __________________ under conditions indicated below:

/ x / Strictly in accordance with the approved itinerary.


To conduct the Private Schools Ocular Inspection
/ / Cut short as explained below. Excess payment in the amount of
₱ _______ was refunded under O.R. No. _________ dated ______________
/ / Extended as explained below, additional itinerary was submitted
/ / Other deviation as explained below.

Explanation or justifications:

Evidence of Travel:

AR, Memo, Travel Order and Certificate of Appearance

Respectfully submitted:

ERVIN I. GALLARDO
Name of Employee

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

Approved:

LOIDA P. ADORNADO, PhD, CESO VI


Assistant Schools Division Superintendent
Officer-In-Charge
Office of the Schools Division Superintendent
DEPARTMENT OF EDUCATION - DIVISION OF OCCIDENTAL MINDORO Fund Cluster :
POLA ELEMENTARY SCHOOL Date:

DV No. :
DISBURSEMENT VOUCHER

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


Payment
_______________________________
TIN/Employee No.: ORS/BURS No.:
Payee ERVIN I. GALLARDO
415-530-096
Address DepEd SDO Occidental Mindoro, Mamburao, Occidental Mindoro
Responsibility
Particulars MFO/PAP Amount
Center

To payment for travelling expenses incurred while on official


travel To conduct the Private Schools Ocular Inspection at
Private Schools in the SDO on March 19-22, 2024
6,900.00

Amount Due 6,900.00


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

RODEL S. MAGNAYE
Chief Education Supervisor
OIC - Assistant Schools Division Superintendent
B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment:


Cash available
Subject to Authority to Debit Account (when applicable)
Sup Supporting documents complete and amount claimed
proper

Signature Signature

Printed Name MERRY ANN T. RAMIREZ, CPA, MBA Printed Name LOIDA P. ADORNADO, PhD, CESO VI
Position Accountant III Position Assistant Schools Division Superintendent
Officer-In-Charge
Office of the Schools Division Superintendent
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. : LBP-0886-1081-76
Date : Printed Name: Date
Signature :
ERVIN I. GALLARDO
Official Receipt No. & Date/Other Documents
DEPARTMENT OF EDUCATION - DIVISION OF OCCIDENTAL MINDORO Fund Cluster :
POLA ELEMENTARY SCHOOL Date:

DV No. :
DISBURSEMENT VOUCHER

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


Payment
_______________________________
TIN/Employee No.: ORS/BURS No.:
Payee ERVIN I. GALLARDO
415-530-096
Address DepEd SDO Occidental Mindoro, Mamburao, Occidental Mindoro
Responsibility
Particulars MFO/PAP Amount
Center

To payment for travelling expenses incurred while on official


travel To conduct the Private Schools Ocular Inspection at
Private Schools in the SDO on March 19-22, 2024

7,300.00

Amount Due 7,300.00


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

ELIZABETH T. DELAS ALAS, PhD


Chief Education Supervisor
Schools Governance and Operations Division
B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment:


Cash available
Subject to Authority to Debit Account (when applicable)
Sup Supporting documents complete and amount claimed
proper

Signature Signature

Printed Name MERRY ANN T. RAMIREZ, CPA, MBA Printed Name LOIDA P. ADORNADO, PhD, CESO VI
Position Accountant III Position Assistant Schools Division Superintendent
Officer-In-Charge
Office of the Schools Division Superintendent
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. : LBP-0886-1081-76
Date : Printed Name: Date
Signature :
ERVIN I. GALLARDO
Official Receipt No. & Date/Other Documents
Puerto Galera
Destination:
Manila

Subic
San Jose
Appendix 11
Serial No. :
OBLIGATION REQUEST AND STATUS _____________________
Date :
DIVISION OF OCCIDENTAL MINDORO
_________________________
Entity Name Fund Cluster :
Payee ___________________
ERVIN I. GALLARDO
Office DepEd, Division of Occidental Mindoro
Address BRGY. 9 MAMBURAO OCCIDENTAL MINDORO
UACS
Responsibility Center Particulars MFO/PAP Object Amount
Code
D-DIVISION TRAVELING EXPENSES-LOCAL 31050010000001000 502101000 6,900.00

Total 6,900.00
B.
A.
Certified: Charges to appropriation/alloment are Certified: Allotment available and obligated
for the purpose/adjustment necessary as
necessary, lawful and under my direct supervision;and indicated above
supporting documents valid, proper and legal

Signature: Signature :
Position: RODEL S. MAGNAYE Printed Name: MILESON P. DELA TORRE
Chief Education Supervisor Position : Budget
Head, Budget Officer V
Division/Unit/Authorized
OIC - Assistant Schools Division Superintendent Representative

Date : ________________________________ Date : ________________________________

C. STATUS OF OBLIGATION
Reference Amount
Balance

ORS/JEV/Check/ ADA/TRA Obligation Payable Payment Not Yet Due and


Date Particulars
No. Due Demandable

(a) (b) (c) (a-b) (b-c)


Appendix 11
Serial No. :
OBLIGATION REQUEST AND STATUS _____________________
Date :
DIVISION OF OCCIDENTAL MINDORO
_________________________
Entity Name Fund Cluster :
Payee ___________________
ERVIN I. GALLARDO
Office DepEd, Division of Occidental Mindoro
Address BRGY. 9 MAMBURAO OCCIDENTAL MINDORO
UACS
Responsibility Center Particulars MFO/PAP Object Amount
Code
D-DIVISION TRAVELING EXPENSES-LOCAL 31050010000001000 502101000 7,300.00

Total 7,300.00
B.
A.
Certified: Charges to appropriation/alloment are Certified: Allotment available and obligated
for the purpose/adjustment necessary as
necessary, lawful and under my direct supervision;and indicated above
supporting documents valid, proper and legal

Signature: Signature :
Position: ELIZABETH T. DELAS ALAS, PhD Printed Name: MILESON P. DELA TORRE
Chief Education Supervisor Position : Budget
Head, Budget Officer V
Division/Unit/Authorized
School Governance and Operations Division Representative

Date : ________________________________ Date : ________________________________

C. STATUS OF OBLIGATION
Reference Amount
Balance

ORS/JEV/Check/ ADA/TRA Obligation Payable Payment Not Yet Due and


Date Particulars
No. Due Demandable

(a) (b) (c) (a-b) (b-c)


ANNEX A

Republic of the Philippines


DEPARTMENT OF EDUCATION
MIMAROPA Region
SCHOOLS DIVISION OF OCCIDENTAL MINDORO
Mamburao, Occidental Mindoro
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017
Name of Employee ERVIN I. GALLARDO Employee No.
Position Senior Education Program Specialist
Division Schools Division of Occidental Mindoro
Particulars Amount (Php)
September 12, 2023
Tricyle 100.00
September 13, 2023
Tricyle 100.00
September 15, 2023
Tricyle 100.00

TOTAL 300.00
Purpose:

To conduct the Private Schools Ocular Inspection

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose,
that the 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 ERVIN I. GALLARDO MARILOU D. PANDIÑO
Senior Education Program Specialist
Position Senior Education Program Specialist OIC-Office of the Chief Education
Supervisor, SGOD
Date: Date:

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