Republic of the Philippines
Province of Cebu
Municipality of Bantayan
APPENDIX - A
BARANGAY SUBA
AGENCY
No. __________________
Date __________________
ITINERARY OF TRAVEL
NAME: _______________________________________________
POSITION: ____________________________________________ MONTHLY SALARY: ______________________
PURPOSE (S) OF TRAVEL:_____________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
ALLOWANCE EXPENSES
PLACES TIME MEANS OF
TOTAL
DATE TO BE TRANS- TOTAL
PER DAILY
VISITED DEPARTURE ARRIVAL PORTATION TRANS
DIEMS ALLOW
I hereby certify that : : (1) Prepared by:
(1) I have reviewed the foregoing itinerary :
(2) the travel is necessary to the service :
(3) the period covered is reasonable : _________________________________
(4) the expense claimed are proper : Name of Official or Employee
:
:
: (2) APPROVED
:
_____________________________________ :
Supervisor : _________________________________
Supervisor
APPENDIX B
______BARANGAY SUBA_______
Agency
CERTIFICATE OF TRAVEL COMPLETED
CLIFFORD A. MAY.. SUBA, BANTAYAN, CEBU
Agency Head Station
BARANGAY CAPTAIN. _________________________
Date
I certify that I have completed the authorized Itinerary of Travel No. ______________ dated
________________________ under the conditions indicated below:
[ ] Strictly in accordance with the 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.
Explanations or Justifications:
_______________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
____________________________________________________________________.
As evidenced of travel attached hereto are:
_______________________________________________________________________________________________________
________________________________________________________________________________________________________________
___________________________________________________________________________________________.
I hereby certify that payment are made after each subsistence was taken.
Respectfully Submitted:
_______________________
Officer or Employee
On evidence and information of which I have knowledge the travel was actually undertaken.
________________________
( Supervisor )