GAAM Vol.
II Appendix 18
Revised January 1992
REIMBURSEMENT EXPENSE RECEIPT
Date: No.
RECEIVED from ______ GIA N. ALVAREZ_____________________
(Name)
_______________TEACHER IN-CHARGE/ T-III________________ ______ the amount of
(Official Designation)
__________________________________________________________________(Php __________)
(In Words) (In Figures)
In payment for _____________________________________________________________________
(Payments for subsistence, services,
rental or transportation should show inclusive dates,
purpose, distance, inclusive points of travel, etc.)
_________________________________________________________________
_________________________________________________________________
PAYEE
Name/Signature: __________________________________________________________________
Address: _________________________________________________________________________
WITNESS
Name/Signature: _____________________________________________________________
Address: ____________________________________________________________________
SAPA DULIAN ELEMENTARY SCHOOL
Zamboanga City
LOCATOR SLIP
REGION: IX- ZAMBOANGA PENINSULA
BURUAEU/DIVISION/SCHOOL: SAPA DULIAN ELEMENTARY SCHOOL, DIVISION OF ZAMBOANGA CITY
DATE OF FILING
NAME
PERMANENT STATION
POSITION/DESIGNATION
PURPOSE/S
PLEASE CHECK Official Personal
DESTINATION
DATE AND TIME OF
EVENT/TRANSACTION/MEETING
Approved:
__________________________ ________ GIA N. ALVAREZ
Signature of Requesting Employee over Printed Name TIC/T-III
Date: _______________________________________ Date: ______________________________
CERTIFICATION
This is to certify that the above mentioned employee appeared in this office for the above purpose/s.
______________________________ _____________________________ ______________________________
Signature over Printed Name Position Date
______________________________ _____________________________ ______________________________
Signature over Printed Name Position Date
________________________ ____________________________ ______________________________
Signature over Printed Name Position Date
______________________________ _____________________________ ______________________________
Signature over Printed Name Position Date
GAAM Vol. II Appendix 18
Revised January 1992
REIMBURSEMENT EXPENSE RECEIPT
Date: No.
RECEIVED from _____________GIA N. ALVAREZ _
(Name)
_______________Teacher In-Charge__________________________ ______ the amount of
(Official Designation)
__________________________________________________________________(Php __________)
(In Words) (In Figures)
In payment for _____________________________________________________________________
(Payments for subsistence, services,
rental or transportation should show inclusive dates,
purpose, distance, inclusive points of travel, etc.)
_________________________________________________________________
_________________________________________________________________
PAYEE
Name/Signature: __________________________________________________________________
Address: _________________________________________________________________________
WITNESS
Name/Signature: _____________________________________________________________
Address: ____________________________________________________________________
