Republic of the Philippines

National Irrigation Administration

PAMBANSANG PANGASIWAAN NG PATUBIG
Ilocos Norte Irrigation Management Office
San Pablo, San Nicolas, Ilocos Norte
Telefax: (077) 770-3858 / 676-1979

DISBURSEMENT VOUCHER

MODE OF
PAYMENT MDS Check Commercial Check ADA

TIN/Employee No.:
PAYEE ANGELICA JOYCE V. IGNACIO

Responsibility Center
ADDRESS SAN NICOLAS, ILOCOS NORTE Office/Unit/Project

EXPLANATION

Reimbursement of travelling expenses and per diems incurred

while on official business as per supporting papers hereto attached in
the amount of …..........

ATTACHMENTS:

Travel Order
Certificate of Appearance
Itinerary of Travel
Certificate of Travel Completed
BTOR

Fund:
ASA #

1 06 10 020 7,480.00
1 01 02 020 7,480.00

Amount Due

A Certified B Approved for Payment

Supporting documents complete and proper

Signature Signature

Printed Name JOHN N. MOLANO Printed Name CZARINE CESS G. A

Supervising Engineer A/ Chief, EOM Section Accounting Pro

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized R

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 Date Date

C Received Payment
Check/ Date Bank Name
ADA No.
Date Printed name
Signature ANGELICA JOYCE V. IGNACIO

Official Receipt/ Other Documents

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 Republic of the Philippines
National Irrigation Administration
BANSANG PANGASIWAAN NG PATUBIG
os Norte Irrigation Management Office
San Pablo, San Nicolas, Ilocos Norte
Telefax: (077) 770-3858 / 676-1979

No.

Others

ORS/BUR No.:

Responsibility Center
Code:

AMOUNT

7,480.00

7,480.00
Approved for Payment

CZARINE CESS G. ALBORNOZ

Accounting Proc. A
Agency Head/Authorized Representative

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 JEV No.

Date

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 Republic of the Philippines
National Irrigation Administration
PAMBANSANG PANGASIWAAN NG PATUBIG
Ilocos Norte Irrigation Management Office
San Pablo, San Nicolas, Ilocos Norte
Telefax: (077) 770-3858 / 676-1979

DISBURSEMENT VOUCHER

MODE OF
PAYMENT MDS Check Commercial Check ADA

TIN/Employee No.:
PAYEE RAYMINOLD P. PATOC

Responsibility Center
ADDRESS SAN NICOLAS, ILOCOS NORTE Office/Unit/Project

EXPLANATION

Reimbursement of travelling expenses and per diems incurred

while on official business as per supporting papers hereto attached in
the amount of …..........

ATTACHMENTS:

Travel Order
Certificate of Appearance
Itinerary of Travel
Certificate of Travel Completed
BTOR

Fund:
ASA #

1 06 10 020 7,480.00
1 01 02 020 7,480.00

Amount Due

A Certified B Approved for Payment

Supporting documents complete and proper

Signature Signature

Printed Name JOHN N. MOLANO Printed Name CZARINE CESS G. A

Supervising Engineer A/ Chief, EOM Section Accounting Pro

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized R

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 Date Date

C Received Payment
Check/ Date Bank Name
ADA No.
Date Printed name
Signature RAYMINOLD P. PATOC

Official Receipt/ Other Documents

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 Republic of the Philippines
National Irrigation Administration
BANSANG PANGASIWAAN NG PATUBIG
os Norte Irrigation Management Office
San Pablo, San Nicolas, Ilocos Norte
Telefax: (077) 770-3858 / 676-1979

No.

Others

ORS/BUR No.:

Responsibility Center
Code:

AMOUNT

7,480.00

7,480.00
Approved for Payment

CZARINE CESS G. ALBORNOZ

Accounting Proc. A
Agency Head/Authorized Representative

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 JEV No.

Date

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 Republic of the Philippines
National Irrigation Administration
PAMBANSANG PANGASIWAAN NG PATUBIG
Ilocos Norte Irrigation Management Office
San Pablo, San Nicolas, Ilocos Norte
Telefax: (077) 770-3858 / 676-1979

DISBURSEMENT VOUCHER

MODE OF
MDS Check Commercial Check ADA
PAYMENT
TIN/Employee No.:
PAYEE NELSON C. BATRINA

Responsibility Center
ADDRESS SAN NICOLAS, ILOCOS NORTE Office/Unit/Project

EXPLANATION

Reimbursement of travelling expenses and per diems incurred

while on official business as per supporting papers hereto attached in
the amount of …..........

ATTACHMENTS:

Travel Order
Certificate of Appearance
Itinerary of Travel
Certificate of Travel Completed
Trip Ticket

Fund:
ASA #

1 06 10 020 3,505.00
1 01 02 020 3,505.00

Amount Due

A Certified B Approved for Payment

Supporting documents complete and proper

Signature Signature

Printed Name JOHN N. MOLANO Printed Name CZARINE CESS G. A

Supervising Engineer A/ Chief, EOM Section Accounting Pro

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized R

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 Date Date

C Received Payment
Check/ Date Bank Name
ADA No.
Date Printed name
Signature NELSON C. BATRINA

Official Receipt/ Other Documents

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 Republic of the Philippines
National Irrigation Administration
BANSANG PANGASIWAAN NG PATUBIG
os Norte Irrigation Management Office
San Pablo, San Nicolas, Ilocos Norte
Telefax: (077) 770-3858 / 676-1979

No.

Others

ORS/BUR No.:

Responsibility Center
Code:

AMOUNT

3,505.00

3,505.00
Approved for Payment

CZARINE CESS G. ALBORNOZ

Accounting Proc. A
Agency Head/Authorized Representative

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 JEV No.

Date

NIA-INIMO-AFD-ACCTG-INT-Form24 Rev.00
 NATIONAL IRRIGATION ADMINISTRATION
ILOCOS NORTE IRRIGATION MANAGEMENT OFFICE
San Nicolas, Ilocos Norte

ITINERARY OF TRAVEL

NAME: NELSON C. BATRINA POSITION: Engineer A - NISRIP

MONTHLY SALARY: P27,754.98 OFFICAL STATION:
PURPOSE OF TRAVEL: To attend Intensive Material Testing and Quality Control Training at NIA LARISIP, Rosales, Pangasinan

TIME MEANS OF
DATE PLACES TO BE DEPAR- TRANSPOR-
ARRIVAL
VISITED TURE TATION
10/7/2019 Official Station to Bauang, La Union 12:00 AM PUB
Bauang, La Union to NIA Regional Office No. 1 4:00 AM PUB
10/7/2019 At NIA Regional Office No. 1 7:00 AM
10/7/2019 NIA Regional Office No. 1 to LARISIP 7:30 AM 8:00 AM PUB
10/7/2019 at LARISIP 8:00 AM 5:00 PM
10/7/2019 LARISIP to NIA Regional Office No. 1 5:00 PM 5:30 PM PUV (c/o PIMO)

10/8/2019 NIA Regional Office No. 1 to LARISIP 7:30 AM 8:00 AM PUV (c/o PIMO)
10/8/2019 at LARISIP 8:00 AM 5:00 PM
10/8/2019 LARISIP to NIA Regional Office No. 1 5:00 PM 5:30 PM PUV (c/o PIMO)

10/9/2019 NIA Regional Office No. 1 to LARISIP 7:30 AM 8:00 AM PUV (c/o PIMO)
10/9/2019 at LARISIP 8:00 AM 5:00 PM
10/9/2019 LARISIP to NIA Regional Office No. 1 5:00 PM 5:30 PM PUV (c/o PIMO)

10/10/2019 NIA Regional Office No. 1 to LARISIP 7:30 AM 8:00 AM PUV (c/o PIMO)
10/10/2019 at LARISIP 8:00 AM 5:00 PM
10/10/2019 LARISIP to NIA Regional Office No. 1 5:00 PM 5:30 PM PUV (c/o PIMO)

10/11/2019 NIA Regional Office No. 1 to LARISIP 7:30 AM 8:00 AM PUV (c/o PIMO)
10/11/2019 at LARISIP 8:00 AM 3:00 PM
10/11/2019 LARISIP to NIA Regional Office No. 1 3:00 PM 3:30 PM PUV (c/o PIMO)
10/11/2019 NIA Regional Office No. 1 to Official Station 4:00 PM 11:35 PM PUB

TOTAL

I CERTIFY that (1) I have reviewed the

foregoing Itenerary.(2) That travel is necessary
to the service. (3) That the period covered is
reasonable. (4) That the expenses claimed
are proper.
JOHN N. MOLANO
Supervisor
TRATION
MENT OFFICE

L
No._________________
Date: _______________
eer A - NISRIP
ILOCOS NORTE IMO
A LARISIP, Rosales, Pangasinan

ALLOWABLE
EXPENSE TOTAL
TRANS PER DIEMS ALLOW
400.00 400.00
120.00
120.00

50.00 50.00

750.00 750.00

300.00 300.00

300.00 300.00

300.00 300.00

535.00 750.00 1,285.00

1,105.00 2,400.00 3,505.00

PREPARED BY:

NELSON C. BATRINA
Employee
APPROVED BY:

DANILO V. GOMEZ
Division Manager A