Republic of the Philippines
MUNICIPAL GOVERNMENT OF SAN JUAN
San Juan, Siquijor
No.
DISBURSEMENT VOUCHER
Mode of Check Cash Others
Payment
TIN/Employee No. Obligation Request No.
Payee
BENJOE MAGLINTE
Responsibility Center
Address San Juan, Siquijor Office/Unit/Project Code
EXPLANATION AMOUNT
To reimburse his travel expenses incurred during the 5-day Climate and Disaster Risk
Assement (CDRA) Writeshop on June 3 to June 7, 2024 in Golden Prince Hotel, Cebu City. ₱2,267.00
A. Certified B. Certified
Allotment to obligation for the purpose as indicated above Funds Available
Supporting documents complete
Signature Signature
Printed Date Printed Date
Name DENNIS S. PATUN-OG Name EMMA P. BALACY
Position MUNICIPAL ACCOUNTANT Position ACTING MUNICIPAL TREASURER
Head, Accounting Unit/Authorized Representative Treasurer/Authorized Representative
C. Approved for Payment D. Received Payment
Check No. Bank Name Date
Signature
Printed Date Signature
Name
HON. WILFREDO Q. CAPUNDAG, JR. Printed Name BENJOE MAGLINTE Date
MUNICIPAL MAYOR
Position OR/Other Documents JEV No. Date
Agency Head, Authorized Representative
Republic of the Philippines
MUNICIPAL GOVERNMENT OF SAN JUAN
San Juan, Siquijor
No.
OBLIGATION REQUEST
Payee BENJOE MAGLINTE
Office MPDO
Address San Juan, Siquijor
Responsibility Account
Center Particulars F.P.P. Code Amount
Attended the 5-day Climate and Disaster Risk
Assement (CDRA) Writeshop on June 3 to June 7, 2024 ₱2,267.00
in Golden Prince Hotel, Cebu City.
Total ₱2,267.00
A. Certified B. Certified
Charges to appropriation/allotment necessary, lawful
and under my direct supervision Existence of available appropriation
Supporting documents valid, proper and legal
Signature Signature
Printed Name LETTY Y. MAMHOT MARILYN N. ONTOLAN
Position MPDC Position MUNICIPAL BUDGET OFFICER
Head, Requesting Office/Authorized Representative Head, Budget Unit/Authorized Representative
Date Date
Revised JANUARY 1992
ITINERARY OF TRAVEL
Name: BENJOE MAGLINTE Position: Administrative Aide I Monthly Salary:
Official Station: Local Government Unit - San Juan, Siquijor Residence: Tubod, San Juan, Siquijor
Purpose of Travel: to attend the 3-day Local Nutrition Action Plan Enhancement Workshop and its Integration in the
Local Development Plan and the Annual Investment Program on September 3 to September 5, 2024 in Dumaguete
City.
Place to be Visited Time Means of Travelling
Date
(Destination) Departure Arrival Transportation Allowance
09/02/2024 Siquijor Pier 5:00PM 5:25PM Hired Motorcycle 200.00
09/02/2024 Dumaguete Pier 6:00PM 6:40PM Fastcraft 350.00
Terminal Fee 14.00
Per Diem 1,440.00
09/03/2024 Venue - Hotel 10:20AM 10:30AM Hired Motorcycle 100.00
09/03-05/2024 Attending the 3-day Workshop for LNAP
09/06/2024 Dumaguete Pier 11:00AM 11:30AM Hired Motorcycle 100.00
09/06/2024 Siquijor Pier 1:00PM 1:40PM Fastcraft 350.00
Terminal Fee 15.00
09/06/2024 Residence 1:50PM 2:15PM Hired Motorcycle 200.00
Per Diem 720.00
Total ₱3,489.00
I certify that (1) I have reviewed the foregoing itinerary,
(2) the travel is necessary to the service, (3) the period covered is Prepared by:
reasonable and (4) the expense claimed are proper.
BENJOE MAGLINTE
ADMINISTRATIVE AIDE I
Supervisor: Approved:
LETTY Y. MAMHOT HON. WILFREDO Q. CAPUNDAG, JR.
MPDC MUNICIPAL MAYOR
ANNEX A
MUNICIPAL GOVERNMENT OF SAN JUAN, SIQUIJOR
(Agency Name)
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017
Name of Employee Employee No.
BENJOE MAGLINTE
Office LGU- San Juan, Siquijor, MPDC Office
Division
Paticulars Amount (₱)
06/02/2024 M-Hire going to Siquijor Pier 200.00
06/03/2024 M-Hire going to Hotel Venue 100.00
06/08/2024 M-Hire going to Cebu Pier 100.00
06/08/2024 M-Hire going to Residence 200.00
TOTAL ₱600.00
Purpose:
Attended the 5-day Climate and Disaster Risk Assement (CDRA) Writeshop on June 3 to June 7,
2024 in Golden Prince Hotel, Cebu City.
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 willful falsification of statements is punishble by law.
Certified Correct: Noted By:
Signature
Printed Name BENJOE MAGLINTE LETTY Y. MAMHOT
Employee Immediate Supervisor
Date
Republic of the Philippines
PROVINCE OF SIQUIJOR
Municipality of San Juan
APPENDIX - B
CERTIFICATE OF TRAVEL COMPLETED
HON. WILFREDO Q. CAPUNDAG, JR. LGU - SAN JUAN, SIQUIJOR
(Agency Head) ( Station )
MUNICIPAL MAYOR DATE :
(Designation)
This is to certify that I have completed the travel authorized in Itinerary of travel while attended the 5-
day Climate and Disaster Risk Assement (CDRA) Writeshop on June 3 to June 7, 2024 in Golden
Prince Hotel, Cebu City.
( x) Strictly in accordance with the approved itinerary
( ) Cut short as explained below. Excess payment in the amount of ______________
( ) Was refunded O. R. No. _____________ dated _______________
( ) Extended as explained below. Additional itinerary was submitted.
( ) Other diviation as explained below.
Explanation of Justification _____________________________________
Certification of travel attached hereto:
( x ) Used Tickets
( x ) Certificate of Appearance
( x ) Itinerary
( x ) Liquidation Report
( x ) Receipt (Registration Fee)
( ) Monthly Accom. Report
( x ) Travel Order
Respectfully submitted:
BENJOE MAGLINTE
ADMINISTRATIVE AIDE I
Evidence and information on which I have knowledge, the travel has actually undertaken.
LETTY Y. MAMHOT
(Supervisor )
Annex 45
LIQUIDATION REPORT No. :
SAN JUAN, SIQUIJOR Date :
LGU Responsibility Center
PARTICULARS AMOUNT
The Travel has been completed and the seminar/workshop has been
successfully attended per the hereto supporting documents in ₱3,489.00
the amount of . . . . . .
TOTAL AMOUNT SPENT ₱3,489.00
AMOUNT OF CASH ADVANCE PER DV NO. _______DTD._______ ₱22,912.00
AMOUNT REFUNDED PER O.R. NO. __________DTD. __________ -
AMOUNT TO BE REIMBURSED ₱2,267.00
Submitted by : Received by:
BENJOE MAGLINTE DENNIS S. PATUN-OG
ADMINISTRATIVE AIDE I Municipal Accountant
Date :
22012
