APPENDIX A

No.
Date:
ITINERARY OF TRAVEL
Name: _______________________________________________ Position: _____________________________
Official Station: ________________________________________ Monthly Salary: ________________________
Purpose of Travel: _____________________________________________________________________________
Means of
Date Place to Visit Departure Arrival Fare Per Diems Total
Transportation

Total
(2) (1) I HEREBY CERTIFY THAT I have reviewed the foregoing (1) Prepared by:
itinerary, (2) the travel is necessary to the service, (3) the period covered
is reasonable, (4) the expenses claimed are proper.
(2) Approved by:

_____________________________________ CRISTITO A. ECO, CESO IV

Supervisor/Immediate Supervisor Schools Division Superintendent

APPENDIX B
Date:
Station:

I hereby certify that I have completed the travel authorized in the Itinerary of Travel No. _______ dated
____________ under the conditions indicated below.

____________ Strictly in accordance with the prepared itinerary.

_____________ Cut short explained below. Excess payment in the amount of ___________________was refund
under O.R. No. __________ dated __________________.
_____________ Extended as explained below: Additional itinerary was submitted:
_____________ Other deviation as explained below:
____________________________________________________________________

Attached supporting documents: ____________________

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

Respectfully submitted:

(Name of employee)
Designation
_CRISTITO A. ECO, CESO IV
Schools Division Superintendent