Reimbursement of Ink

Republic of the Philippines
Municipality of Dimasalang
Province of Masbate
DISBURSEMENT VOUCHER No.

Mode of
Payment Check Cash Others
Payee TIN/Employee No: Obligation Request No.

MELBA G. VALLENA
Address: Responsibilty Center

Dimasalang, Masbate
Office/Unit/Project Code:
EXPLANATION AMOUNT
To reimbursement of miscellaneous expenses as per

attached official receipt in the total amount of …………. Php 1,150.00
Total Php 1,150.00

A Certified B Certified
Allotment obligation for the purpose as indicated above Funds Available
Supporting documents complete
Signature Signature
Printed Date Printed Date

MELBA G. VALLENA MELBA G. VALLENA
Name Name
Position: Treasurer,ICO Position: Municipal Treasurer

Head, Treasurer's Office/Authorized Representative Treasurer/Authorized Representative
C Approved for Payment D Received Payment
Signature Check No. Bank Name Date
Printed Date Signature

HENRY J. NAGA
Name Printed MELBA G. VALLENA Date
Name Claimant
Position: Municipal Mayor OR/Other Documents JEV No. Date
Agency Head/Authorized Representative
Province of Masbate
OBLIGATION REQUEST No.

Payee MELBA G. VALLENA
OFFICE Treasurer, ICO
LGU-Dimasalang, Masbate
Address
Responsibility Account
Particulars F.P.P Amount
Center Code
Reimbursement- Misc. Exp. Php 1,150.00
TOTAL Php 1,150.00

Certified: Certified:
A B
Charges to appropriation/allotment necessary,
lawful and under my direct supervision. Existence of available appropriation
Supporting documents valid, proper and legal
Signature Signature
Printed Printed
MELBA G. VALLENA NATHANIEL T. ARREGADAS
Name Name
Position Treasurer, ICO Position Municipal Budget Officer

Head, Requesting Office/Authorized Representative Head, Budget Office/Authorized Representative
Date Date
Province of Masbate
DISBURSEMENT VOUCHER No.

Mode of
Payment Check Cash Others
Payee Obligation Request No.
ALEJANDRO A. TAMAYO
Address: Responsibilty Center

DIM., MAS.
Office/Unit/Project Code:
EXPLANATION AMOUNT
To payment of my travelling expenses to attend the special National Conference

& Seminar Workshop on Oct. 14-17, 2009 at Waterfront Hotel, Lahug, Cebu city
in the amount of eleven Thousand pesos only . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,000.00
Total 11,000.00
Certified Certified
A Allotment obligation for the purpose as indicated above B Funds Available
Supporting documents complete
Signature Signature
Printed Date Printed

MARIETA G. DADAL MELBA G. VALLENA
Name Name
Position: Municipal Accountant Position: Municipal Treasurer

Head, Accounting Unit/Authorized Representative Treasurer/Authorized Representative
Approved for Payment Received Payment
Signature
C Check
D No. Bank Name
Printed Date Signature

HENRY J. NAGA
Name Printed
ALEJANDRO A. TAMAYO
Name
Position: Municipal Mayor OR/Other Documents JEV No.
Agency Head/Authorized Representative
MOUNT
Date
al Treasurer
rized Representative
Date
Date
Date
Province of Masbate
Office of the Mun. S.B.
ITINERARY OF TRAVEL
NAME MARFA R. LIM

POSITION S.B. MEMBER MONTHLY SALARY P
OFFICIAL STATION LGU-Dimasalang, Masbate
PURPOSE OF TRAVEL See attached Travel order
Place to be TIME Means of ALLOWANCES Amount

Date Visited or Travel Departure Arrival Transportation Transpor- Daily Total
Per Diems
tation Fare Allowance
02/02/10 Dim.-Cebu Term 11:00AM 9:45PM Roro Bus 650.00 800.00

02/03/10 Still in Cebu 800.00
02/04/10 Cebu-Davao 7:00AM 8:00AM Plane 8,426.88 400.00
Davao-Gen.San. Van 800.00
02/05/10
9,876.88 - 2,000.00 11,876.88
I HEREBY CERTIFY that (1) I have MARFA R. LIM

reviewed the foregoing itinerary. (2) The Official or Employee
travel is necessary to the service.
(3) The period covered is reasonable. Municipal Assessor
(4) The expense claimed are proper. Designation
APPROVED:
HON. HENRY J. NAGA

Head of Office
Province of Masbate
Office of the Mun. Mayor
CERTIFICATE OF TRAVEL COMPLETED
Hon. Henry J. Naga LGU-dim. Mas.

(Chief of Office) (Station)
MUN. Mayor
(Designation) (Date)
I HEREBY CERTIFY that I have completed the travel authorized in the Itenerary of Travel
No.________________________dated________________2010, under condition indicated below:
Strictly in accordance with the approved itinerary.

Cut short as explained below. Excess payment in the amount P___________was
refunded under O.R No. ___________dated______________2008.
Extended to other deviations as explained below:
EXPLANATION OR JUSTIFICATIONS: __________________________________________________

__________________________________________________________________________________
EVIDENCE OF TRAVEL ATTACHED HERETO:CERTIFICATE OF APPEARANCE & TICKETS
receipts
Respectfully Submitted:
MABEL G. VALLENA
(Official or Employee)
Agriculturist II
(Designation)
On evidence and information of which I have knowledge, tha travel was actually undertaken.
HON. HENRY J. NAGA

(Chief of Office)
MUN. Mayor
(Designation)
y of Travel
ertaken.
Province of Masbate
ITINERARY OF TRAVEL
NAME HELENA C. HUELVA

POSITION Day Care Worker MONTHLY SALARY P
OFFICIAL STATION LGU-Dimasalang, Masbate
PURPOSE OF TRAVEL See Attachment Papers
Place to be TIME Means of ALLOWANCES Amount

Date Visited or Travel Departure Arrival Transportation Transpor- Daily Total
Per Diems
tation Fare Allowance
04/16/2009 Dim-Masbate 7:00am 8:00am Aircon Van 70.00 70.00
Masbate-Dim. 4:00pm 5:00pm Aircon Van 70.00 320.00 390.00
04/22/2009 Dim-Palanas 7:00am 8:00am Tricykle 40.00 40.00
Palanas-Dim 4:00pm 5:00pm Trcykle 40.00 100.00 140.00
10/12/2009 Dim.-Mas. 5:00am 6:00am Airconvan 70.00 70.00
Mas.-Pilar 8:30am 10:30am Vessel 200.00 200.00
Pilar-Legaspi 11:00am 12:nn Jeep 70.00 800.00 870.00
10/13-14/2009 Still in DSWD Legaspi City 1,600.00 1,600.00
10/15/2009 Legaspi-Pilar - -
Pilar-Masabte Vessel 200.00 320.00 520.00
Masbate-Dim. Garbage Truck - -
Bill of lading ( Utensils) 400.00 400.00
Trucking of Utensils from

DSWD Legaspi to Pilar 1,500.00 1,500.00
Miscellaneous Expenses:
Hauling and Handling of Utensils from
DWSD Legaspi, Pilar & Masbate 1,500.00 1,500.00
10/28/2009 Dim-Divisoria 7:00am 8:00am Special Hire 300.00 100.00 400.00

Divisoria-Dim. 4:00pm 5:00pm -

6,140.00 - 7,080.00 13,220.00
I HEREBY CERTIFY that (1) I have
reviewed the foregoing itinerary. (2) The HELENA C. HUELVA
travel is necessary to the service. Official or Employee
(3) The period covered is reasonable.
(4) The expense claimed are proper. Day Care Worker
Designation
APPROVED:
GHENLHE R. SANCHEZ
SWO III
NATIONAL POLICE COMMISSION
PHILIPPINES NATIONAL POLICE
Dimasalang, Municipal Police Station
Dimasalang, Masbate
SUBSISTENCE ALLOWANCE
For the Month of September, 2010
NR RANK/NAME AMOUNT SIGNATURE
1 PINS ARIEL NERI D 800.00

2 SP03 NOEL BANDA D 400.00
3 SP01 EDGAR VILLAMOR B 400.00
4 P03 ARMANDO, SR ANONUEVO D 400.00
5 P03 ROY ALMIÑE D 400.00
6 P03 EDGAR PORLAJE A 400.00
7 P03 ALMARIO CRISTOBAL G 400.00
8 P03 ALDRIN ALMOCERA B 400.00
9 P03 EDGAR CANTONJOS H 400.00
10 P02 JESUS APOSTOL P 400.00
11 P02 JONATHAN ROBAS R 400.00
12 P02 PAJALLA BERNARDO, JR G 400.00
13 P02 LANIE GUAÑEZO V 400.00
14 P02 EDIMAR MANLANGIT B 400.00
15 P02 REYNALDO VILLARANTE B 400.00
16 P02 SHERWIN ASILUM E 400.00
17 P01 JOSEPH BULTRON L 400.00
18 PO1 MISAEL III CABRERA T 400.00
19 P01 MA. DOLORES ABENIA P 400.00
20 P01 ROBERT RUBIDO G 400.00
21 P01 NICANOR GOC-ONG B 400.00
22 P01 JAIME POTOT 400.00
23 P01 AVELINI III BADILLO A 400.00
24 NUP GRACE AFABLE A 400.00
Total 10,000.00
PINS ARIEL D. NERI

Chief of Police-Dimasalang, Masbate

Reimbursement of Ink

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Republic of the Philippines

DISBURSEMENT VOUCHER No.

Payee TIN/Employee No: Obligation Request No.

Address: Responsibilty Center

To reimbursement of miscellaneous expenses as per

Total Php 1,150.00

Printed Date Printed Date

Position: Treasurer,ICO Position: Municipal Treasurer

Printed Date Signature

OBLIGATION REQUEST No.

OFFICE Treasurer, ICO

Reimbursement- Misc. Exp. Php 1,150.00

TOTAL Php 1,150.00

Position Treasurer, ICO Position Municipal Budget Officer

DISBURSEMENT VOUCHER No.

Address: Responsibilty Center

To payment of my travelling expenses to attend the special National Conference

Printed Date Printed

Position: Municipal Accountant Position: Municipal Treasurer

Printed Date Signature

NAME MARFA R. LIM

Place to be TIME Means of ALLOWANCES Amount

02/02/10 Dim.-Cebu Term 11:00AM 9:45PM Roro Bus 650.00 800.00

9,876.88 - 2,000.00 11,876.88

I HEREBY CERTIFY that (1) I have MARFA R. LIM

HON. HENRY J. NAGA

CERTIFICATE OF TRAVEL COMPLETED

Hon. Henry J. Naga LGU-dim. Mas.

Strictly in accordance with the approved itinerary.

EXPLANATION OR JUSTIFICATIONS: __________________________________________________

HON. HENRY J. NAGA

NAME HELENA C. HUELVA

Place to be TIME Means of ALLOWANCES Amount

10/13-14/2009 Still in DSWD Legaspi City 1,600.00 1,600.00

Bill of lading ( Utensils) 400.00 400.00

Trucking of Utensils from

10/28/2009 Dim-Divisoria 7:00am 8:00am Special Hire 300.00 100.00 400.00

11/19/2009 Dim-Masbate 7:00am 8:00am Aircon Van 70.00 70.00

NR RANK/NAME AMOUNT SIGNATURE

1 PINS ARIEL NERI D 800.00

PINS ARIEL D. NERI

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