CHECKLIST OF REQUIREMENTS FOR TRAVEL

PLEASE DO NOT DETACH

TRAVEL REIMBURSEMENT DepEdRO8 FD-F19
Obligation Request and Status (ORS)
Disbursement Voucher (DV)
AR/ATC
Certificate of Travel Completed
Memorandum of Activity
Itinerary of Travel
Certificate of Expenses
Tickets/Official Receipt
Boarding Pass
Approved Travel Order
Post Travel Report
Certificate of Appearance
Landbank Account No. (for 1st time payees of RO8)

Justification
Certification from Budget and Accountant/Bookkeeper
Special Order for School Head and Division Chiefs and Higher
 Appendix 11

OBLIGATION REQUEST AND STATUS Serial No. :

Department of Education Date :
REGIONAL OFFICE NO. VIII (EASTERN VISAYAS) Fund Cluster :
Government Center, Candahug Palo, Leyte

Payee ISIDRO C. CATUBIG

Office Division of Southern Leyte

Address DepEd Southern Leyte Division Office, Mantahan, Maasin City

Responsibility UACS Object

Particulars MFO/PAP Amount
Center Code

For payment of the travel to REL-NEAP, 1,650.00

Regional Office VIII, Government Center,
Candahug, Palo, Leyte on February 28-
29, 2024, per suppporting papers hereto
attached.

Total 1,650.00
A. Certified: Charges to appropriation/alloment are B. Certified: Allotment available and obligated
necessary, lawful and under my direct supervision;an for the purpose/adjustment necessary as
supporting documents valid, proper and legal indicated above

Signature
Signature :
:
Printed
Name: Printed Name:
JOSILYN S. SOLANA EdD, CESO V
Position : Schools Division Superintendent Position :
Head, Requesting Office / Authorized Head, Budget Division / Unit / Authorized
Representative 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)
 Appendix 32

Fund Cluster :
Department of Education
REGIONAL OFFICE NO. VIII (EASTERN VISAYAS) Date
DV :
No.
Government Center, Candahug Palo, Leyte :

DISBURSEMENT VOUCHER
Mode of
MDS Check Commercial Check ADA Others (Pls specify)
Payment

TIN/Employee No.: ORS/BURS No.:

Payee ISIDRO C. CATUBIG
108-070-365

Address DepEd Southern Leyte Division Office, Mantahan, Maasin City

Responsibility
Particulars MFO/PAP Amount
Center

For payment of the travel to REL-NEAP, Regional

Office VIII, Government Center, Candahug, Palo, 1,650.00
Leyte on February 28-29, 2024, per suppporting
papers hereto attached.

Amount Due 1,650.00

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

B. Accounting Entry:
Account Title UACS Code Debit Credit

C. Certified: D. Approved for Payment

Cash available

Subject to Authority to Debit Account (when a

Sup
proper

Signature Signature

Printed Printed
Name ULLYSES SABANDAL Name JOSILYN S. SOLANA EdD, CESO V
Position Accountant III Position Schools Division Superintendent

Date Date

E. Receipt of Payment JEV No.

Check/ Date : Bank Name & Account
ADA No. : Number: LBP - SA 000
Signature Date : Printed Name: Date
:
Official Receipt No. & Date/Other Documents
 Republic of the Philippines
Department of Education
REGIONAL OFFICE NO. VIII (EASTERN VISAYAS)
Government Center, Candahug, Palo, Leyte
DIVISION OF SOUTHERN LEYTE
Mnathan, Maasin City
ITINERARY OF TRAVEL

Fund Cluster: No.: __________________

Name : ARCADIO S. SANTIZAS Date of Travel : July 18, 2024

Position : HT-III Purpose of Travel : To attend orientation on the Land Bank of the
Official Station
Concepcion ES-Sogod 2 Philippines (LBP) opening of local currency current accounts (LCCA).

Places to be visited TIME Means of Total

Date Transportati Per Diem Others
(Destination) Departure Arrival Transportation on Amount

07/18/2024 Station to Maasin City 5:50 AM 7:30 AM van 150.00 600.00 750.00
Maasin City to Station 5:03 PM 6:35 PM van 150.00
150.00

TOTAL ₱ 300.00 600.00 900.00

Prepared by :

I certify that : (1) I have reviewed the foregoing itinerary, ARCADIO S. SANTIZAS
(2) the travel is necessary to the service, (3) the Employee
period covered is reasonable and (4) the expenses
claimed are proper. Approved by:

ISIDRO C. CATUBIG EdD, CESE JOSILYN S. SOLANA EdD, CESO V

Assistant Schools Division Superintedent Schools Division Superintendent
Immediate Supervisor Agency Head/Authorized Representative
 Republic of the Philippines
Department of Education
REGIONAL OFFICE NO. VIII (EASTERN VISAYAS)
Government Center, Candahug, Palo, Leyte
DIVISION OF SOUTHERN LEYTE

CERTIFICATION OF TRAVEL COMPLETED

Entity Name: Department of Education Fund Cluster:

JOSILYN S. SOLANA EdD, CESO V Concepcion ES-Sogod 2

Schools Division Superintendent Station

I HEREBY CERTIFY THAT I have completed the travel as authorized in the Travel Order / Locator Slip
Itinerary of Travel/Regional Memos/Division No. 226, 194, 182
under conditions indicated below:

[ x ] Strictly in accordance with the approved itinerary.

[ ] Cut short as explained below. Excess payment in the amount of
Php was refunded under O.R. No. __________ dated ________.
[ ] Extended as explained below, additional itinerary was submitted.
[ ] Other deviation as explained below.

Explanation of Justification:

Evidence of Travel:
Certificate of Appearance, Trip Tickets, etc.

Respectfully submitted:

ARCADIO S. SANTIZAS
Employee

On evidence and information of which I have the knowledge, travel was actually undertaken.

Approved:

JOSILYN S. SOLANA EdD,

CESO V
Immediate Head
 Annex A

Department of Education
REGIONAL OFFICE NO. VIII (EASTERN VISAYAS)
DIVISION OF SOUTHERN LEYTE

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017

Name of Employee: ISIDRO C. CATUBIG Employee No.: 3823

Division: Catbalogan City Division
Particulars Amount

MCH fare from Tacloban Airport to Grandtours Terminal ₱ 150.00

TOTAL ₱ 150.00
Purpose
To attend the 52nd Integrated SALDIWA in Quezon City and in Bataan for Community Engagement

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:
Printed Name: ISIDRO C. CATUBIG EdD, CESE JOSILYN S. SOLANA EdD, CESO V
Employee Immediate Supervisor
Date: 29/9/2023 Date: 29/9/2023

Annex A

Department of Education
REGIONAL OFFICE NO. VIII (EASTERN VISAYAS)
Government Center, Candahug Palo, Leyte

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated June 19, 2017
Name of Employee: ISIDRO C. CATUBIG Employee No.: 3823
Division: Catbalogan City Division
Particulars Amount

MCH fare from Tacloban Airport to Grandtours Terminal ₱ 150.00

TOTAL ₱ 150.00
Purpose
To attend the 52nd Integrated SALDIWA in Quezon City and in Bataan for Community Engagement

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:
Printed Name: ISIDRO C. CATUBIG EdD, CESE JOSILYN S. SOLANA EdD, CESO V
Employee Immediate Supervisor
Date: 29/9/2023 Date: 29/9/2023