Template With Checklist On Travel Claims For Teachers

DV#: _____________________________
Disbursement Voucher
Itinerary of Travel
Certificate of Travel Complete
Certificate of Non-Receipt Requirements
Travel Order
Certificate of Appearance
Memorandum (if applicable)
Official Receipts (if applicable)
Remarks
Certificate of Non-Receipt Requirements is applicable for expenses amount

300 below without the availability of Receipt
For Teachers , signatories for recommending Approval is he School Heads
and Approving Authority is the Public Schoo;l District Supervisor
For Travels though Airplane of by ship Official Receipt is required
For expenses amount 301 above use RER

Checked by:
ERLYN A. UMAMBAC
ADAS III
Remarks
Republic of the Philippines
Department of Education
Region IX, Zamboanga Peninsula
DIVISION OF ZAMBOANGA DEL SUR
Provincial Government Center, Dao, Pagadian City, Zamboanga del Sur
ITINERARY OF TRAVEL
NAME: CHENNEE PEARL R. BLANCIA Date: July 21-26, 2024

Official Station: Zamboanga del Sur Position:
To attend the Regional-Based Training on Multigrade Instruction for Teachers in

Purposes of Travel: the ast Mile Schools
July 21-26, 2024.
Places to be Time Means of Allowable

Date
Visited Departure Arrival Trans Trans
6/21/2024 Residence - Molave Van Terminal 6:00 AM 6:45 AM Motorcycle 20.00
Molave Van Terminal- Dipolog Van Terminal 10:00 AM 12:05 PM Van 280.00
Dipolog Van Terminal-Mibang Hotel, Dipolog City 12:07 PM 1:00 PM Tricycle 70.00
7:00 AM 8:00 AM
July 22-25,
2024 Session Proper 12:00 AM 1:30 PM
6:00 PM 8:00 PM
6/26/2024 Mibang Hotel-Dipolog Van Terminal 6:00 AM 10:00 AM Tricycle 80.00

Dipolog Van Terminal-Molave Van Terminal 1:00 PM 3:00 PM Van 280.00
Molave Van Terminal-Residence 3:00 PM 7:00 PM Motorcycle 20.00
(2) I certify that: (a) I have reviewed the foregoing TOTAL: 750.00
itinerary; (b) the travel is necessary to the
service; (c) the period covered is reasonable Prepared by:
and (d) the expenses claimed are proper.
CHENNEE PEARL R. BLANCIA
Recommending Approval: Teacher I
APPROVED:
Evelyn S. Ronquillo
Principal/School Head
Roland S. Toledo
Public School District Supervisor
del Sur
21-26, 2024
Instruction for Teachers in
Per
TOTAL
Diem
20.00
280.00
70.00
750.00 830.00
280.00
20.00
750.00 1,500.00
EE PEARL R. BLANCIA
Teacher I
nd S. Toledo
ool District Supervisor
Republic of the Philippines
Region IX, Zamboanga Peninsula
DIVISION OF ZAMBOANGA DEL SUR
Pagadian City
CERTIFICATE OF TRAVEL COMPLETED
DR. JEANELYN A. ALEMAN, CESO V DepED-Division of Zamboanga del Sur

Agency Head Station
SDS,
7/21-26/2024
Office of the Schools Division Superintendent
Designation Date
I certify that I have completed the travel authorized in the itinerary of travel no. _______
Dated 7/21-26/2024 under the condition indicated below:
x Strictly in accordance with approved itinerary
Cut short as explained below. Excess payment in the amount of Php _______
was refunded on official receipt number ___________ dated _____________
Extended as to explained below. Additional itinerary was submitted.
Other deviation as explained below.
Evidence or justification:
Evidence of travel hereto attached:

1. Travel Order
2. Certificate of Appearance
3. Memorandum
CHENNEE PEARL R. BALNCIA

Teacher I
On evidence and information of which I have knowledge, the travel was actually
undertaken.
EVELYN S. RONQUILLO
School Head
CIA
Region IX – Zamboanga Peninsula
Division of Zamboanga del Sur
ANNEX A
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001- dated June 19, 2017
Name of Employee CHENNEE PEARL R. BALNCIA Employee
No.
Office
Division
Date Particulars Amount ((₱)
7/21/2024 Motorcycle fare expense from Residence to Molave Van Terminal 20.00
Van fare expense from Molave Van Terminal to Dipolog Van Terminal 280.00
Tricycle fare expense from Dipolog Van Terminal to Mibang Hotel, Dipolog City 70.00
7/26/2024 Tricycle fare expense from Mibang Hotel, Dipolog City toDipolog Van Terminal 80.00
Van fare expense from Dipolog Van Terminal to Molave Van Terminal 280.00
Motorcycle fare expense from Molave Van Terminal to Residence 20.00
x-x-x-x-x-x-x-x-x-x-x
Subtotal 750.00
Purposes:
To attend the Regional-Based Training on Multigrade Instruction for Teachers in the last Mile Schools on July 21-26, 2024
I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose that above goods and
services were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of statements is punishable
by law.
Certified Correct: Noted By:
Signature:
CHENNEE PEARL R. BLANCIA EVELYN S. RONQUILLO

Printed Name:
Teacher I Principal/School Head
Employee Immediate Supervisor
Date 7/27/2024 Date 7/27/2024
ANNEX A
Amount ((₱)
20.00
280.00
70.00
80.00
280.00
20.00
750.00
chools on July 21-26, 2024
that above goods and

of statements is punishable
LYN S. RONQUILLO
ncipal/School Head
mediate Supervisor
27/2024
Appendix 46
REIMBURSEMENT EXPENSE RECEIPT
Entity Name: _________________ Fund Cluster : ________________

Date : _______________________ RER No. : ___________________
RECEIVED from ______________________________________

(Name)
_________________________________________________ the amount
(Official Designation)
of __________________________________________ (P__________)
(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 ________________________________________________

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DV#: _____________________________

Certificate of Non-Receipt Requirements is applicable for expenses amount

For Travels though Airplane of by ship Official Receipt is required

For expenses amount 301 above use RER

NAME: CHENNEE PEARL R. BLANCIA Date: July 21-26, 2024

To attend the Regional-Based Training on Multigrade Instruction for Teachers in

Places to be Time Means of Allowable

6/26/2024 Mibang Hotel-Dipolog Van Terminal 6:00 AM 10:00 AM Tricycle 80.00

Instruction for Teachers in

CERTIFICATE OF TRAVEL COMPLETED

DR. JEANELYN A. ALEMAN, CESO V DepED-Division of Zamboanga del Sur

x Strictly in accordance with approved itinerary

Extended as to explained below. Additional itinerary was submitted.

Other deviation as explained below.

Evidence of travel hereto attached:

CHENNEE PEARL R. BALNCIA

CHENNEE PEARL R. BLANCIA EVELYN S. RONQUILLO

chools on July 21-26, 2024

that above goods and

REIMBURSEMENT EXPENSE RECEIPT

Entity Name: _________________ Fund Cluster : ________________

RECEIVED from ______________________________________

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Entity Name: _ Fund Cluster :