Republic of the Philippines

Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: MARY GRACE L. AGUSTIN Position: ADAS II
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel: Attended the Special Meeting at SDO Isabela

Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
SDO CONFERENCE HALL, DIVISION
OFFICE, ALIBAGU ILAGAN CITY,
11/9/2023 ISABELA 6:30 AM 6:34 AM ANCS to Terminal (Tricycle) 20.00 20.00

6:45 7:45 AM Alicia to Ilagan Terminal (Bus) 100.00 100.00

Ilagan Terminal to Division Office
7:45 7:57 (tricycle) 20.00 20.00
Division Office to Ilagan Terminal
1:15 PM 1:21 PM (Tricycle) 20.00 20.00
Ilagan Terminal to Alicia
1:30 PM 2:45 PM Terminal (bus) 100.00 100.00
Ilagan Terminal to Alicia North
2:45 PM 2:50 PM C/S (tricycle) 20.00 20.00
-
280.00

Total 280.00
**Two hundred eighty pesos only **
Prepared by:

MARY GRACE L. AGUSTIN

Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

GEMMA M. LANDICHO
Principal I
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: MARY GRACE L. AGUSTIN Position:
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel:

Time Expenses
Date Places to be Visited Means of Transportation Incidental Meal
Departure Arrival Transportation Allowance Allowance Total

180.00
3/10/2023 Baguio Teachers Camp 6:00 PM 2:30 A.M Tricycle/VAN/taxi 1,170.00 360.00 1,710.00
(Dinner)

920 250 1020

180.00
4/10/2023 Baguio Teachers Camp 8:00 AM 5:00 PM Tricycle/VAN/taxi - 360.00 540.00
(Breakfast)

1500

5/10/2023 Baguio Teachers Camp 8:00 AM 5:00 PM Tricycle/VAN/taxi - 360.00 0 360.00

180.00
6/10/2023 Baguio Teachers Camp 1:30 PM 9:05 PM Tricycle/VAN/taxi 1,170.00 360.00 1,710.00
(Dinner)

GRAND
P 4,320.00
TOTAL

Total
**Four thousand three hundred twenty pesos only **
Prepared by:

MARY GRACE L. AGUSTIN

Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

GEMMA M. LANDICHO
Principal I
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: GEMMA M. LANDICHO Position: PRINCIPAL I
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel: To attend the Division forum on the Omnibus Guidelines on the regulation of operations of the Parent-teacher associations

Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
SDO CONFERENCE HALL, DIVISION
OFFICE, ALIBAGU ILAGAN CITY,
09/20/2023 ISABELA 6:30 AM 6:34 AM ANCS to Terminal (Tricycle) 20.00 20.00

6:45 7:45 AM Alicia to Ilagan Terminal (Bus) 100.00 100.00

Ilagan Terminal to Division Office
7:45 7:57 (tricycle) 20.00 20.00
Division Office to Ilagan Terminal
1:15 PM 1:21 PM (Tricycle) 20.00 20.00
Ilagan Terminal to Alicia
1:30 PM 2:45 PM Terminal (bus) 100.00 100.00
Ilagan Terminal to Alicia North
2:45 PM 2:50 PM C/S (tricycle) 20.00 20.00
-
280.00

Total
**Two hundred eighty pesos only **
Prepared by:

GEMMA M. LANDICHO
Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

JACQUELINE S. RAMOS, PhD, CESE

OIC-Assistant Schools Division Superintendent
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: ISIDORO M. MARTINEZ JR. & NIÑA ANGELAH N. TAMANI Position: TEACHER III/SELG PRESIDENT, ANCS & AND
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel: To Attend the conduct of SELG, SSLG, YES-O, KID and BKD Division Federation Elections for S.Y 2023-2024 at Nagulian National High School,
Nagulian, Isabela

Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
Nagulian National High School,

07/06/2023 Nagulian, Isabela 6:30 AM 6:34 AM ANCS to Terminal (Tricycle) 30.00 30.00
Alicia Terminal to Nagulian
6:45 7:45 AM National High School 180.00 180.00
Nagulian National High School to
1:05 2:05 Alicia Terminal 180.00 180.00

2:05 PM 2:10 PM Alicia Terminal to ANCS (Tricycle) 30.00 30.00

-
420.00

Total 420.00
**Four hundred twenty pesos only **

Prepared by:

ISIDORO M. MARTINEZ JR
Official Employee

NIÑA ANGELAH N. TAMANI

Official Employee

I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

GEMMA M. LANDICHO
Principal I
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: SHERYLL B. CORPUZ Position: Teacher III
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel: To Attend the Division DRRM Module Roll out for School DRRM Coordinators.

Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
Water World Grand Resort, Purok

4/5/2023 4 Raniag, Ramon, Isabela 10:00 AM 10:03 AM ANCS to Terminal (Tricycle) 20.00 20.00
10:03 to 10:33 AM Alicia to SM CAUAYAN (Bus) 50.00 50.00

10:46 11:48 SM Cauayan to Ramon terminal 80.00 80.00

11:50 12:20 PM Ramon terminal to Water World 50.00 50.00

7/5/2023 Alicia North Central School 2:15 PM 2:34 Water World to Ramon terminal 50.00 50.00
Ramon terminal to SM Cauayan
2:40 3:45 Terminal 80.00 80.00
SM Cauayan terminal To Alicia
3:56 4:35 terminal 50.00 50.00
Alicia terminal to Alicia North
4:36 4:40 C/S 20.00 20.00
-
400.00

Total 400.00
**Four HUNDRED Pesos Only **
Prepared by:

SHERYLL B. CORPUZ
Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

GEMMA M. LANDICHO
Principal I
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: MANILENE R. RAMISCAL Position: ADAS III
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel: Attended the Special Meeting at SDO Isabela

Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
SDO CONFERENCE HALL, DIVISION
OFFICE, ALIBAGU ILAGAN CITY,
11/9/2023 ISABELA 6:30 AM 6:34 AM ANCS to Terminal (Tricycle) 20.00 20.00

6:45 7:45 AM Alicia to Ilagan Terminal (Bus) 100.00 100.00

Ilagan Terminal to Division Office
7:45 7:57 (tricycle) 20.00 20.00
Division Office to Ilagan Terminal
1:15 PM 1:21 PM (Tricycle) 20.00 20.00
Ilagan Terminal to Alicia
1:30 PM 2:45 PM Terminal (bus) 100.00 100.00
Ilagan Terminal to Alicia North
2:45 PM 2:50 PM C/S (tricycle) 20.00 20.00
-
280.00

Total 280.00
**Two hundred eighty pesos only **
Prepared by:

MANILENE R. RAMISCAL
Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

GEMMA M. LANDICHO
Principal I
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: GEMMA M. LANDICHO Position: PRINCIPAL I
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel: To Attend the Orientation on the Administration of Comprehensive Rapid Literacy Assessment Tool (CRLA) Tool

Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
SDO CONFERENCE HALL, DIVISION
OFFICE, ALIBAGU ILAGAN CITY,
07/03/2023 ISABELA 6:00 AM 6:05 AM ANCS to Terminal (Tricycle) 20.00 20.00

6:15 7:15 AM Alicia to Ilagan Terminal (Bus) 100.00 100.00

Ilagan Terminal to Division Office
7:15 7:25 (tricycle) 50.00 50.00
Division Office to Ilagan Terminal
5:15 PM 5:25 AM (Tricycle) 50.00 50.00
Ilagan Terminal to Alicia
5:45 6:45 AM Terminal (bus) 100.00 100.00
Ilagan Terminal to Alicia North
6:47 6:53 C/S (tricycle) 20.00 20.00
-
340.00

Total 340.00
**Three hundred forty pesos only **
Prepared by:

GEMMA M. LANDICHO
Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

EDNA P. ABUAN, PhD

Assistant Schools Division Superintendent
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: MARY GRACE L. AGUSTIN Position: ADAS II
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel: To Attend the 3RD QUARTER TECHNICAL ASSISTANCE ON FINANCIAL AND ADMINISTRATIVE MATTERS TO CENTRAL SCHOOL AND
NEWLY APPOINTED ADMINISTRATIVE ASSISTANTS & SPECIAL MEETING AT SDO ISABELA

Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
SDO CONFERENCE HALL, DIVISION
OFFICE, ALIBAGU ILAGAN CITY,
08/30/2023 ISABELA 6:30 AM 6:34 AM ANCS to Terminal (Tricycle) 20.00 20.00
6:45 7:45 AM Alicia to Ilagan Terminal 100.00 100.00

7:45 7:57 Ilagan Terminal to Division Office 20.00 20.00

5:15 AM 5:25 AM Division Office to Ilagan Terminal 50.00 50.00

5:45 6:45 AM Ilagan Terminal to Alicia Terminal 100.00 100.00

Alicia Terminal to Alicia North
6:47 6:53 C/S 20.00 20.00
SDO CONFERENCE HALL, DIVISION
OFFICE, ALIBAGU ILAGAN CITY,
11/9/2023 ISABELA 6:30 AM 6:34 AM ANCS to Terminal (Tricycle) 20.00 20.00

6:45 7:45 AM Alicia to Ilagan Terminal (Bus) 100.00 100.00

Ilagan Terminal to Division Office
7:45 7:57 (tricycle) 20.00 20.00
Division Office to Ilagan Terminal
1:15 PM 1:21 PM (Tricycle) 20.00 20.00
Ilagan Terminal to Alicia
1:30 PM 2:45 PM Terminal (bus) 100.00 100.00
Ilagan Terminal to Alicia North
2:45 PM 2:50 PM C/S (tricycle) 20.00 20.00
-
590.00

Total 590.00
**Five hundred ninety pesos only **
Prepared by:

MARY GRACE L. AGUSTIN

Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

GEMMA M. LANDICHO
Principal I
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: DEBRA V. RAMOS Position: Teacher III
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel: To pick up MADRASAH Supplies.
Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
01/18/2023 DepEd-DO,Ilagan City 10:30 AM 2:30 PM ANCS to Terminal (Tricycle) 15.00 15.00
Alicia to Alibagu (Bus) 100.00 100.00
Alibagu to DepEd (tricycle) 15.00 15.00
Deped to Alibagu (tricycle) 30.00 30.00
Alibagu to Alicia (bus) 100.00 100.00

Alicia Terminal to ANCS (tricycle) 30.00 450.00 480.00

740.00

Total 740.00
**SEVEN HUNDRED FORTY Pesos Only **
Prepared by:

DEBRA V. RAMOS
Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

GEMMA M. LANDICHO
Principal I
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: DELMAR G. REYES Position: Teacher III
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel:
Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
01/18/2023 DepEd-DO,Ilagan City 10:30 AM 4:30 PM ANCS to SES 25.00 25.00
SES to San Pablo ES 30.00 30.00
San Pablo ES to Callao 15.00 15.00
Callao to San Pedro ES 40.00 40.00
San Pedro ES to MNKES 40.00 40.00
MNKES to Sto. Domingo ES 25.00 25.00
Sto. Domingo ES to Amistad ES 25.00 25.00
Amistad ES to San Juan ES 30.00 30.00

San Juan ES to San Francisco ES 40.00 40.00

San Francisco ES to Rizal ES 40.00 40.00
Rizal ES to Paddad 25.00 25.00
Paddad to ANCS 35.00 35.00
ANCS to Linglingay ES 20.00 20.00
Linglingay ES to ANCS 20.00 80.00 100.00 490.00

Total 490.00
**SEVEN HUNDRED FORTY Pesos Only **
Prepared by:

DELMAR G. REYES
Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

GEMMA M. LANDICHO
Principal I

DGR
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
Alicia North Central School
Antonino, Alicia, Isabela
APPENDIX A
(ITINERARY OF TRAVEL)
Name: MANILENE R. RAMISCAL Position: ADAS III
Official Station: ALICIA NORTH CENTRAL SCHOOL
Purpose of Travel:
Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
01/18/2023 DepEd-DO,Ilagan City 10:30 AM 4:30 PM ANCS to SES 25.00 25.00
SES to San Pablo ES 30.00 30.00
San Pablo ES to Callao 15.00 15.00
Callao to San Pedro ES 40.00 40.00
San Pedro ES to MNKES 40.00 40.00
MNKES to Sto. Domingo ES 25.00 25.00
Sto. Domingo ES to Amistad ES 25.00 25.00
Amistad ES to San Juan ES 30.00 30.00

San Juan ES to San Francisco ES 40.00 40.00

San Francisco ES to Rizal ES 40.00 40.00
Rizal ES to Paddad 25.00 25.00
Paddad to ANCS 35.00 35.00
ANCS to Linglingay ES 20.00 20.00
Linglingay ES to ANCS 20.00 80.00 100.00 490.00

Total 490.00
**SEVEN HUNDRED FORTY Pesos Only **
Prepared by:

MANILENE R. RAMISCAL
Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.

GEMMA M. LANDICHO
Principal I

DGR
 Republic of the Philippines
Department of Education
Region 02
Division of Isabela
RIZAL REGION NATIONAL HIGH SCHOOL
Alicia
APPENDIX A
(ITINERARY OF TRAVEL)
Name: RAYMARK S. JOSE Position: ADAS 3
Official Station: RIZAL REGION NATIONAL HIGH SCHOOL
Purpose of Travel: To submit reports and other documents
Time Expenses
Date Places to be Visited Means of Transportation
Departure Arrival Transportation Per Diem Amount - Grand Total
3/17/2022 LBP,Alicia 10:00 AM 2:00 PM RIzal to Paddad (Tricycle) 50.00 50.00
RIzal to Alicia Centro-LBP
(Tricycle) 50.00 50.00
LBP to Paddad (Tricycle) 50.00 50.00
Paddad to Rizal (Tricycle) 50.00 50.00

- 200.00
3/25/2022 LBP,Alicia 10:00 AM 2:00 PM RIzal to Paddad (Tricycle) 50.00 50.00
RIzal to Alicia Centro-LBP
(Tricycle) 50.00 50.00
LBP to Paddad (Tricycle) 50.00 50.00
Paddad to Rizal (Tricycle) 50.00 50.00

- 200.00
3/28/2022 LBP,Alicia 10:00 AM 2:00 PM RIzal to Paddad (Tricycle) 50.00 50.00
RIzal to Alicia Centro-LBP
(Tricycle) 50.00 50.00
LBP to Paddad (Tricycle) 50.00 50.00
Paddad to Rizal (Tricycle) 50.00 50.00

- 200.00
DepEd-RO PSU, Tuguegarao
3/29/2022 City 6:00 AM 6:00 PM RIzal to Paddad (Tricycle) 50.00 50.00
Paddad to Tuguegarao (Bus) 350.00 350.00
Tuguegarao City to DepEd-RO
(Tricycle) 50.00 50.00

DepEd-RO to Terminal (Tricycle) 50.00 50.00

DepEd-DO, Ilagan City Terminal to Ilagan City (Bus) 250.00 250.00
Ilagan to DepEd-DO (Tricycle) 30.00 30.00

DepEd-DO to Terminal (Tricycle) 30.00 30.00

Ilagan to Paddad (Bus) 100.00 100.00
Paddad to Rizal (Tricycle) 50.00 750.00 800.00
- 1,710.00

Total 2,310.00
**TWO THOUSAND THREE HUNDRED TEN Pesos Only **
Prepared by:
RAYMARK S. JOSE
Official Employee
I Certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable and (4) the expenses claimed is proper.
LORDINO G. ANTONIO
Principal I
 Republic of the Philippines
DEPARTMENT OF EDUCATION (07001)
Region 02
SCHOOLS DIVISION OF ISABELA (0802003)
City of Ilagan

Fund Center:

DISBURSEMENT VOUCHER Date :

DV No. :

Mode of
MDS Check Commercial Check ADA Others (Please Specify)
Payment
TIN/Employee No.: ORS/BURS No.:
Payee RAYMARK S. JOSE

Address Alicia, Isabela

Responsibility Center MFO/ PAP Amount

To payment of Travelling Expenses

in the amount of…. #REF!

Amount Php #REF!

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

JULIETA M. DOMINGO, PRINCIPAL IV

Printed Name, Designation and Signature of Supervisor

B. Accounting Entry :
Account Tiltle UACS CODE Debit Credit
Travelling Expenses 5020201001 #REF!
Cash, MDS 1010404000 #REF!

C. Certified: D. Approved for Payment

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

Signature Signature

Printed Name CELSO C. LIBED Printed Name JULIETA M. DOMINGO, EdD

Administrative Assistant II Principal IV

Position Position
Disbursing Officer 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

 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region 02
SCHOOLS DIVISION OF ISABELA
City of Ilagan

Serial No. : 01-01101101-2022-10-00114

OBLIGATION REQUEST AND STATUS _____________
Date : ___
________
Fund Cluster : 01
_____________
Payee ______
RAYMARK S. JOSE
Office RIZAL REGION NATIONAL HIGH SCHOOL
Address
ALICIA ISABELA
UACS Object
Responsibility Center Particulars MFO/PAP Amount
Code

To payment of Travelling Expenses

Travelling Expenses 5020201001 #REF!

-
-
-
-

Total #REF!

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: JULIETA M. DOMINGO, EdD Printed Name: RAYMARK S. JOSE

Position : Principal IV Position : Administrative Assistant III

Head, Requesting Office/
Authorized Representative Head, Budget 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)
 Republic of the Philippines
DEPARTMENT OF EDUCATION (07001)
Region 02
SCHOOLS DIVISION OF ISABELA (0802003)
City of Ilagan

Fund Center:

DISBURSEMENT VOUCHER Date :

DV No. :

Mode of
MDS Check Commercial Check ADA Others (Please Specify)
Payment
TIN/Employee No.: ORS/BURS No.:
Payee SHIRLEY JOY C. SIQUIAN

Address Alicia, Isabela

Responsibility Center MFO/ PAP Amount

To payment of Travelling Expenses

in the amount of…. #REF!

Amount Php #REF!

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

JULIETA M. DOMINGO, PRINCIPAL IV

Printed Name, Designation and Signature of Supervisor

B. Accounting Entry :
Account Tiltle UACS CODE Debit Credit
Travelling Expenses 5020201001 #REF!
Cash, MDS 1010404000 #REF!

C. Certified: D. Approved for Payment

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

Signature Signature

Printed Name CELSO C. LIBED Printed Name JULIETA M. DOMINGO, EdD

Administrative Assistant II Principal IV

Position Position
Disbursing Officer 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

 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region 02
SCHOOLS DIVISION OF ISABELA
City of Ilagan

Serial No. : 01-01101101-2022-08-00101

OBLIGATION REQUEST AND STATUS _____________
Date : ___
________
Fund Cluster : 01
_____________
Payee ______
VARIOUS PAYEE
Office RIZAL REGION NATIONAL HIGH SCHOOL
Address
ALICIA ISABELA
UACS Object
Responsibility Center Particulars MFO/PAP Amount
Code

To payment of Travelling Expenses

Travelling Expenses 5020201001 #REF!
400.00
360.00
1,080.00
400.00
-

Total #REF!

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: JULIETA M. DOMINGO, EdD Printed Name: RAYMARK S. JOSE

Position : Principal IV Position : Administrative Assistant III

Head, Requesting Office/
Authorized Representative Head, Budget 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)