DEPARTMENT OF EDUCATION

NATIONAL CAPITAL REGION

Quezon City

APPENDIX B
CERTIFICATE OF TRAVEL COMPLETED

Name: Station:
Designation: Date:

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 on O.R. No.
dated submitted.

Other deviations as explained below.

Explanations/justifications:

Evidence of travel attached hereto:

Check No.:
Date Issued:
Amount:

Purpose of Travel:

Respectfully submitted:

(Name of Participant)

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

GENIA V. SANTOS
ed/5-15-2015 CHIEF, CLMD
 DEPARTMENT OF EDUCATION
NATIONAL CAPITAL REGION
Quezon City

APPENDIX A
ITINERARY OF TRAVEL / SUMMARY OF EXPENSES

NAME: Official Station :

POSITION Division / Unit :

PURPOSE OF TRAVEL:

VENUE DATE:

Time Means of
DATE Places to be visited Departure Arrival Trans. Expenses Per Diem Total

TOTAL -
I certify that (1) have reviewed the foregoing itinerary (2) Prepared by:
the travel is necessary to the service. (3) the period
claimed is reasonable and (4) the expenses clained are
proper
Name & Signature of Participant

Recommending Approval:

GENIA V. SANTOS APPROVED:

Chief, CLMD

WILFREDO E. CABRAL
Officer-In-Charge
clmd/ed Office of the Regional Director
GENERAL FORM NO. 2 GENERAL FORM NO. 2
REVISED JANUARY 1992 REVISED JANUARY 1992

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT

Date: No. Date: No.

Received from Received from

the amount the amount
(Official Designation) (Official Designation)

of (P ) of (P )
(In figure) (In figure)
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
Comm. Tax Cert. No. Comm. Tax Cert. No.
Date of Issue Date of Issue
Place of Issue Place of Issue

WITNESS WITNESS
Name/Signature Name/Signature
Address Address
Comm. Tax Cert. No. Comm. Tax Cert. No.
Date of Issue Date of Issue
Place of Issue Place of Issue
GENERAL FORM NO. 2 GENERAL FORM NO. 2
REVISED JANUARY 1992 REVISED JANUARY 1992

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT

Date: No. Date: No.

Received from Received from

the amount the amount
(Official Designation) (Official Designation)

of (P ) of (P )
(In figure) (In figure)
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
Comm. Tax Cert. No. Comm. Tax Cert. No.
Date of Issue Date of Issue
Place of Issue Place of Issue

WITNESS WITNESS
Name/Signature Name/Signature
Address Address
Comm. Tax Cert. No. Comm. Tax Cert. No.
Date of Issue Date of Issue
Place of Issue Place of Issue