Appendix 11

OBLIGATION REQUEST AND STATUS No:

Department of Environment and Natural Resources Region-10 Date:
PENR Office, Pigcarangan, Tubod, Lanao del Norte Fund:
Payee SARIPA B. MUSOR
Office DENR, PENRO LDN
Address PIGCARANGAN TUBOD LDN
Responsibility UACS Object
Particulars MFO/PAP Amount
Center Code

To reimburse payment of paycheck in the

P 455.00
total amount of…

TOTAL P 455.00
A. Certified: Charges to appropriation/allotment B. Certified: Allotment available and obligated
necessary, lawful and under my direct supervision, for the purpose/adjustment necessary as
and supporting documents valid, proper and legal. indicated above

Signature Signature :
Printed Name HERMOSILLA C. FLORES Printed Name : MYZARAH M. MACUD
Position Chief, MSD Position : Acting Budget Officer
Head, Requesting Office/Authorized Head, Budget Unit/Authorized
Representative Representative
Date Date :

STATUS OF OBLIGATION
C.
Reference Amount
Balance
ORS/JEV/Check/ADA/TRA Not Due and
Date Particulars Obligation Payable Payment Demandable
No. Yet
Due Demandable

To reimburse payment
of paycheck in the total
amount of…

Budget Date/Time Received if necessary: Date/Time Returned to Requesting Office Budget Date/Time Released

Date/Time Returned to Accounting Office

 EXPENSE MONITORING FORM
Control No. ___________________________ Unit _______________ Dare Release___________________
ROA No. ____________ CENRO/PENRO _________ Date of Check ____________________
Date Prepared _____________ Fund ____________________
PAYEE: NORJANNAH M. MANGADANG

Actual Amount
Activity Code Activity Description Purpose Amount Requested Annual Obligation
Disbursed

Prepared by: Approved by:

EULALIA P. JALOVA ARNULFO T. OSIO

Budget Focal OIC-PENR Officer

EXPENSE MONITORING FORM

Control No. ___________________________ Unit _______________ Dare Release___________________
ROA No. ____________ CENRO/PENRO _________ Date of Check ____________________
Date Prepared _____________ Fund ____________________
PAYEE: NORJANNAH M. MANGADANG

Actual Amount
Activity Code Activity Description Purpose Amount Requested Annual Obligation
Disbursed

Prepared by: Approved by:

EULALIA P. JALOVA ARNULFO T. OSIO

Budget Focal OIC-PENR Officer

EXPENSE MONITORING FORM

Control No. ___________________________ Unit _______________ Dare Release___________________
ROA No. ____________ CENRO/PENRO _________ Date of Check ____________________
Date Prepared _____________ Fund ____________________
PAYEE: NORJANNAH M. MANGADANG

Actual Amount
Activity Code Activity Description Purpose Amount Requested Annual Obligation
Disbursed

Prepared by: Approved by:

EULALIA P. JALOVA ARNULFO T. OSIO

Budget Focal OIC-PENR Officer
 Appendix 11

OBLIGATION REQUEST AND STATUS No:

Department of Environment and Natural Resources Region-10 Date:
PENR Office, Pigcarangan, Tubod, Lanao del Norte Fund:
Payee NIÑA NASEEFAH B. MUSOR
Office DENR, PENRO LDN
Address PIGCARANGAN TUBOD LDN
Responsibility UACS Object
Particulars MFO/PAP Amount
Center Code

To obligate payment of of Wages for the

period of January-March 2023 in the total P 53,196.00
amount of…

TOTAL P 53,196.00
A. Certified: Charges to appropriation/allotment B. Certified: Allotment available and obligated
necessary, lawful and under my direct supervision, for the purpose/adjustment necessary as
and supporting documents valid, proper and legal. indicated above

Signature Signature :
Printed Name HERMOSILLA C. FLORES Printed Name : MYZARAH M. MACUD
Position Chief, MSD Position : Acting Budget Officer
Head, Requesting Office/Authorized Head, Budget Unit/Authorized
Representative Representative
Date Date :

STATUS OF OBLIGATION
C.
Reference Amount
Balance
ORS/JEV/Check/ADA/TRA Not Due and
Date Particulars Obligation Payable Payment Demandable
No. Yet
Due Demandable

To obligate payment of
of Wages for the period
of January-March 2023
in the total amount of…

Budget Date/Time Received if necessary: Date/Time Returned to Requesting Office Budget Date/Time Released

Date/Time Returned to Accounting Office

 Appendix 11

OBLIGATION REQUEST AND STATUS No:

Department of Environment and Natural Resources Region-10 Date:
PENR Office, Pigcarangan, Tubod, Lanao del Norte Fund:
Payee NORJANNAH M. MANGADANG
Office DENR, PENRO LDN
Address PIGCARANGAN TUBOD LDN
Responsibility UACS Object
Particulars MFO/PAP Amount
Center Code

To payment of Travelling Expenses in the

P 2,000.00
amount of…

TOTAL P 2,000.00
A. Certified: Charges to appropriation/allotment B. Certified: Allotment available and obligated
necessary, lawful and under my direct supervision, for the purpose/adjustment necessary as
and supporting documents valid, proper and legal. indicated above

Signature Signature :
Printed Name HERMOSILLA C. FLORES Printed Name : MYZARAH M. MACUD
Position Chief, MSD Position : Acting Budget Officer
Head, Requesting Office/Authorized Head, Budget Unit/Authorized
Representative Representative
Date Date :

STATUS OF OBLIGATION
C.
Reference Amount
Balance
ORS/JEV/Check/ADA/TRA Not Due and
Date Particulars Obligation Payable Payment Demandable
No. Yet
Due Demandable

To payment of Travelling
Expenses in the amount
of…

Budget Date/Time Received if necessary: Date/Time Returned to Requesting Office Budget Date/Time Released

Date/Time Returned to Accounting Office

 Appendix 11

BUDGET UTILIZATION REQUEST AND STATUS No:

Department of Environment and Natural Resources Region-10 Date:
PENR Office, Pigcarangan, Tubod, Lanao del Norte Fund:
Payee SARIPA B. MUSOR
Office DENR , PENRO LDN
Address PIGCARANGAN TUBOD LDN
Responsibility
Particulars MFO/PAP UACS Object Code Amount
Center

To payment of my Traveling Expenses in

₱ 6,600.00
the total amount of…

TOTAL ₱ 6,600.00
A. Certified: Charges to appropriation/allotment B. Certified: Allotment available and obligated
necessary, lawful and under my direct supervision, for the purpose/adjustment necessary as
and supporting documents valid, proper and legal. indicated above

Signature Signature :
Printed Name MAMACAYA M. LUCMAN, AL-HAJ Printed Name : ELIZABETH OMAHOY
Position PENR Officer Position : Acting Budget Officer
Head, Requesting Office/Authorized Head, Budget Unit/Authorized
Representative Representative
Date Date :

STATUS OF OBLIGATION
C.
Reference Amount
Balance
ORS/JEV/Check/ADA/TRA Due and
Date Particulars Obligation Payable Payment Not Yet Demandable
No.
Due Demandable
 Appendix 32
Fund Cluster:
Republic of the Philippines
Department of Environment and Natural Resources Date:
PENR Office, Pigcarangan Tubod, Lanao del Norte DV No. :

DISBURSEMENT VOUCHER

Mode of MDS Check Commercial Check ADA Others

Payment

TIN/Employee No. ORS/BURS No.:

Payee NORJANNAH M. MANGADANG

Address DENR, PENRO LDN

Responsibility
Particulars MFO/PAP Amount
Center

To payment of travelling expense in the total amount of ….. ₱ 2,000.00

₱ 2,000.00
A. Certified : Expenses/Cash Advances necessary, lawful and incurred under my direct supervision.

HERMOSILLA C. FLORES
Chief, MSD

B. Accounting Entry:

Account Title UACS Code Debit Credit

C. Certified : D. Approved for Payment

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete and amount claimed

Signature Signature

Printed Name ASKARI T. DIMAPORO Printed Name ARNULFO T. OSIO

Accountant III OIC-PENR Officer

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Received Payment JEV No.
Check/ Bank Name & Account Number:
Date
ADA No.
Printed Name: Date
Signature Date2
NORJANNAH M. MANGADANG
Official Receipt No. & Date/Other Documents
Accounting Date/Time Received if necessary: Date/Time Returned to Requesting Office Accounting Date/Time Released

Date/Time Returned to Accounting Office

 Appendix 32
Fund Cluster:
Republic of the Philippines
Department of Environment and Natural Resources Date:
PENR Office, Pigcarangan Tubod, Lanao del Norte DV No. :

DISBURSEMENT VOUCHER

Mode of MDS Check Commercial Check ADA Others

Payment

TIN/Employee No. ORS/BURS No.:

Payee SARIPA B. MUSOR

Address DENR, PENRO LDN

Responsibility
Particulars MFO/PAP Amount
Center

To payment of Travelling Expenses in the amount of… ₱ 3,000.00

₱ 3,000.00
A. Certified : Expenses/Cash Advances necessary, lawful and incurred under my direct supervision.

HERMOSILLA C. FLORES
Chief, MSD

B. Accounting Entry:

Account Title UACS Code Debit Credit

C. Certified : D. Approved for Payment

Cash Available
Subject to Authority to Debit Account (when applicable)
Supporting documents complete and amount claimed

Signature Signature

Printed Name ASKARI T. DIMAPORO Printed Name SAMER C. AMBOLA

Accountant III OIC-PENR Officer

Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Received Payment JEV No.
Check/ Bank Name & Account Number:
Date
ADA No. DBP- 5-77512-820-4
Printed Name: Date
Signature Date2
SARIPA B. MUSOR
Official Receipt No. & Date/Other Documents
Accounting Date/Time Received if necessary: Date/Time Returned to Requesting Office Accounting Date/Time Released

Date/Time Returned to Accounting Office

 Form No. 34
Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
E-mail Add: r10penro.lanaodelnorte@gmail.com
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

TRAVEL ORDER

(No.____________________________)

Name : CHRISTINE V. ESPARAS Salary :

Position : ADMINISTRATIVE ASSISTANT Div.Sec./Unit : MSD
Departure Date : April 12, 2024 Official Station : DENR-PENRO LDN
Destination : LLRMSFR VISITOR CENTER Return Date : April 12, 2024
Purpose of Travel : To Deliver paycheck, Voucher and other documents.

Per Diems/Expenses Allowed :

Assistance of Laborers Allowed : None
Appropriations to which travel should be charged:
Remarks or special instructions:
Certifications:

This is to certify that travel is necessary and is connected with the functions of
the official/employee of this Div./Sec./Unit

Recommending Approval: Approved:

HERMOSILLA C. FLORES ARNULFO T. OSIO

CHIEF Management Services Division OIC-PENR Officer

AUTHORIZATION

I hereby authorize the Accountant to deduct the corresponding amount of the unliquidated cash advance
from my succeeding salary for my failure to liquidate this travel within the prescribed thirty-day period upon
return to my permanent official station pursuant to item 5, 1, 3, COA Circular 97-002 dated February 10, 1997 and
Sec. 16 EO No. 248 dated May 29, 1995.

CHRISTINE V. ESPARAS
Official / Employee
 Form No. 34
Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
E-mail Add: r10penro.lanaodelnorte@gmail.com
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

TRAVEL ORDER

(No.____________________________)

Name : NIÑA NASEEFAH B. MUSOR - H. MOAMAR Salary :

Position : ADMINISTRATIVE ASSISTANT Div.Sec./Unit : MGMT Services Div.
Departure Date : March 17, 2023 Official Station : DENR-PENRO LDN
Destination : Ilicomm, Iligan City Return Date : March 17, 2023
Purpose of Travel : To deliver payment and collect official receipt of Ilicomm Enterprises at Ilicomm, Iligan City,

Per Diems/Expenses Allowed :

Assistance of Laborers Allowed :
Appropriations to which travel should be charged:
Remarks or special instructions:
Certifications:

This is to certify that travel is necessary and is connected with the functions of
the official/employee of this Div./Sec./Unit

Recommending Approval: Approved:

HERMOSILLA C. FLORES SAMER C. AMBOLA

Chief, MSD OIC-PENR Officer

AUTHORIZATION

I hereby authorize the Accountant to deduct the corresponding amount of the unliquidated cash advance
from my succeeding salary for my failure to liquidate this travel within the prescribed thirty-day period upon
return to my permanent official station pursuant to item 5, 1, 3, COA Circular 97-002 dated February 10, 1997 and
Sec. 16 EO No. 248 dated May 29, 1995.

NIÑA NASEEFAH B. MUSOR - H. MOAMAR

Official / Employee
 Form No. 34
Republic of the Philippines
Community of Environment and Natural Resources Office-Iligan City
Liangan-Lipatan River Mangrove Swamp Forest Reserve/Bacolod-Kauswagan Protected Landscape and Seascape

E-mail Add: r10penro.lanaodelnorte@gmail.com

Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

TRAVEL ORDER

(No.____________________________)

Name : KHALID P. AROBINTO Salary :

Position : DRIVER Div.Sec./Unit :
Departure Date : March 04, 2024 Official Station : LLRMSFR/BKPLS
Destination : CENRO Iligan and RGT Car Repair Shop Arrival Date : March 08, 2024
Purpose of Travel : To convey LLRMSFR Staff and Bantay Dagat at CENRO Iligan to participate the blood letting activity;
To convey BKPLS vehicle (VAN F2J013) at RGT car Repair Shop.

Per Diems/Expenses Allowed :

Assistance of Laborers Allowed :
Appropriations to which travel should be charged:
Remarks or special instructions:
Certifications:

This is to certify that travel is necessary and is connected with the functions of
the official/employee of this Div./Sec./Unit

Recommending Approval: Approved:

GRACE A. LAPECIROS SAIBEN P. MAMPAO

Deputy PASu/LLRMSFR OIC-CENR Officer

AUTHORIZATION

I hereby authorize the Accountant to deduct the corresponding amount of the unliquidated cash advance
from my succeeding salary for my failure to liquidate this travel within the prescribed thirty-day period upon
return to my permanent official station pursuant to item 5, 1, 3, COA Circular 97-002 dated February 10, 1997 and
Sec. 16 EO No. 248 dated May 29, 1995.

KHALID P. AROBINTO
Official / Employee
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

Name: SARIPA B. MUSOR Departure Date: March 02, 2022

Position: ACTING CASHIER Arrival Date: March 02, 2022

ITINERARY OF TRAVEL
Place to be visited Time Means of Traveling
DATE Fare Per Diem
(Destination) Departure Arrival transportation Allowance
Station to DBP, Iligan
VAN 200.00 1,000.00
City
2-Mar-22 800.00
Back to Station VAN 200.00 200.00

Sub-Total 400.00 800.00 1,200.00

* * * Nothing Follows * * *

TOTAL 1,200.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
SARIPA B. MUSOR
Employee

Approved by: (Head of Agency)

HERMOSILLA C. FLORES SAMER C. AMBOLA

Chief, Management Services Division OIC-PENR Officer
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

Name: NORJANNAH M. MANGADANG Departure Date: February 20, 2024

Position: ADMINISTRATIVE ASSISTANT Arrival Date: February 21, 2024

ITINERARY OF TRAVEL
Place to be visited Time Means of Traveling
DATE Fare Per Diem
(Destination) Departure Arrival transportation Allowance
Station to Tubod Motorcycle 40.00 280.00
LDN Terminal
To Tominobo VAN 130.00 130.00
20-Feb-24 Terminal 240.00

To CENRO Iligan TAXI 120.00 120.00

CENRO ILIGAN TO
TOMINOBO TERMINAL MOTORCYCLE 50.00 50.00
20-Feb-24
TOMINOBO TO VAN 130.00 130.00
STATION

Sub-Total 470.00 240.00 710.00

* * * Nothing Follows * * *

TOTAL 710.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
NORJANNAH M. MANGADANG
Employee

Approved by: (Head of Agency)

ARNULFO T. OSIO
OIC, PENR Officer
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

Name: NIÑA NASEEFAH MUSOR Departure Date: April 05, 2019

Position: ADMINISTRATIVE ASSISTANT Arrival Date: April 05, 2019

ITINERARY OF TRAVEL
Place to be visited Time Means of Traveling
DATE Fare Per Diem
(Destination) Departure Arrival transportation Allowance
Station to Tubod Motorcycle 25.00 25.00
LDN Terminal
To Tominobo VAN 80.00 80.00
Terminal

To DBP Iligan TAXI 120.00 120.00

5-Apr-19
DBP to Tominobo
TAXI 120.00 120.00
Terminal
To Tubod LDN VAN 80.00 80.00
Terminal

Back to Station Motorcycle 25.00 25.00

Sub-Total 450.00 - 450.00

* * * Nothing Follows * * *

TOTAL 450.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
NIÑA NASEEFAH MUSOR
Employee

Approved by: (Head of Agency)

MAMACAYA M. LUCMAN
PENR Officer
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

Name: NIÑA NASEEFAH MUSOR Departure Date: July 30, 2019

Position: ADMINISTRATIVE ASSISTANT Arrival Date: July 30, 2019

ITINERARY OF TRAVEL
Place to be visited Time Means of Traveling
DATE Fare Per Diem
(Destination) Departure Arrival transportation Allowance
Station to Tubod Motorcycle 25.00 25.00
LDN Terminal
To Tominobo VAN 80.00 80.00
Terminal

To DBP Iligan TAXI 120.00 120.00

30-Jul-19
DBP to Tominobo
TAXI 120.00 120.00
Terminal
To Tubod LDN VAN 80.00 80.00
Terminal

Back to Station Motorcycle 25.00 25.00

Sub-Total 450.00 - 450.00

* * * Nothing Follows * * *

TOTAL 450.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
NIÑA NASEEFAH MUSOR
Employee

Approved by: (Head of Agency)

MAMACAYA M. LUCMAN
PENR Officer
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

Name: NORJANNAH MANGADANG Departure Date:March 15, 2024

Position: ADMINISTRATIVE ASSISTANT Arrival Date: March 15, 2024

ITINERARY OF TRAVEL
Place to be visited Time
Means of Per Diem/Meal Traveling
DATE Fare Allowance
(Destination) Departure Arrival transportation Allowance

Official Station to VAN 90.00 330.00

15-Mar-24 LLRMSFR VISITOR 240.00
CENTER RACAL 15.00 15.00

VAN 90.00 100.00

15-Mar-24 BACK TO STATION
RACAL 15.00 15.00

Sub-Total 210.00 240.00 460.00

* * * Nothing Follows * * *

TOTAL 460.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
NORJANNAH MANGADANG
Employee

Recommending Approval: Approved by: (Head of Agency)

HERMOSILLA C. FLORES ARNULFO T. OSIO

Chief, MSD OIC-PENR Officer
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

Name: NIÑA NASEEFAH MUSOR Departure Date:March 17, 2023

Position: ADMINISTRATIVE ASSISTANT Arrival Date: March 17, 2023

ITINERARY OF TRAVEL
Place to be visited Time
Means of Per Diem/Meal Traveling
DATE Fare Allowance
(Destination) Departure Arrival transportation Allowance

Official Station to VAN 180.00 680.00

Tominobo Terminal
Tominobo Terminal Habal-Habal 70.00 70.00
to CENRO, Iligan City
17-Mar-23 500.00
CENRO, Iligan City to Habal-Habal 70.00 70.00
Tominobo Terminal

Back to Station VAN 180.00 180.00

Sub-Total 500.00 500.00 1,000.00

* * * Nothing Follows * * *

TOTAL 1,000.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
NIÑA NASEEFAH MUSOR
Employee

Recommending Approval: Approved by: (Head of Agency)

HERMOSILLA C. FLORES SAMER C. AMBOLA

Chief, MSD OIC-PENR Officer
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

Name: SARIPA MUSOR Departure Date:December 12, 2023

Position: AOIV/Acting Cashier Arrival Date: December 12, 2023

ITINERARY OF TRAVEL
Place to be visited Time Means of Traveling
DATE Fare Per Diem
(Destination) Departure Arrival transportation Allowance
PENR Office to tubod Motor 40.00 40.00
LDN Terminal
Tubod Terminal to
Suarez terminal Van 180.00 1,980.00

Suarez Terminal to DBP

ILIGAN BRANCH Taxi 200.00 200.00
12-Dec-23 1,800.00
DBP TO CENRO Taxi 100.00 100.00
ILIGAN
CENRO ILIGAN TO Taxi 200.00 200.00
TERMINAL

Back to Station Motor 180.00 40.00

Sub-Total 900.00 1,800.00 2,700.00

* * * Nothing Follows * * *

TOTAL 2,700.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
SARIPA B. MUSOR
Employee

Recommending Approval: Approved by: (Head of Agency)

HERMOSILLA C. FLORES ARNULFO T. OSIO

Chief, MSD OIC-PENR Officer
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

Name: SARIPA MUSOR Departure Date:December 21, 2021

Position: AOIV/Acting Cashier Arrival Date: December 22, 2021

ITINERARY OF TRAVEL
Place to be visited Time Means of Traveling
DATE Fare Per Diem
(Destination) Departure Arrival transportation Allowance
Official Station to VAN 170.00 1,970.00
Tominobo Terminal
1,800.00
Tominobo Terminal JEEP 24.00 24.00
12/21- to DBP Iligan City
22/2021
JEEP 24.00 424.00
Back to Station 400.00
VAN 170.00 170.00

Sub-Total 388.00 2,200.00 2,588.00

* * * Nothing Follows * * *

TOTAL 2,588.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
SARIPA B. MUSOR
Employee

Approved by: (Head of Agency)

MAMACAYA M. LUCMAN
PENR Officer
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

Name: SARIPA B. MUSOR Departure Date: November 10, 2022

Position: AOIV/Acting Cashier Arrival Date: November 11, 2022

ITINERARY OF TRAVEL
Place to be visited Time Means of Traveling
DATE Departur Fare Per Diem
(Destination) Arrival transportation Allowance
e
Official Station to VAN 170.00 1,970.00
Tominobo Terminal
Tominobo Terminal to Jeep 30.00 30.00
Tambo Terminal
10-Nov-22 1,800.00
Tambo Terminal to VAN 250.00 250.00
Bulua Terminal
Bulua Terminal to
PUJ 85.00 85.00
Region 10

Still at Venue 800.00 800.00

Region 10 to Bulua
PUJ 85.00 85.00
Terminal
11-Nov-22
Bulua Terminal to
VAN 250.00 250.00
Tambo Terminal

Back to Residence Jeep 30.00 30.00

Sub-Total 900.00 2,600.00 3,500.00

* * * Nothing Follows * * *
TOTAL 3,500.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
SARIPA B. MUSOR
Employee

Recommending Approval: Approved by: (Head of Agency)

HERMOSILLA C. FLORES SAMER C. AMBOLA

Chief, MSD OIC-PENR Officer
535.00

335.00
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte
Telephone No.: (063) 227-6070 Fax No.: (063) 227-6070

Name: SARIPA B. MUSOR Departure Date: August 01, 2022

Position: AOIV/Acting Cashier Arrival Date: August 02, 2022

ITINERARY OF TRAVEL
Place to be visited Time Means of Traveling
DATE Departur Fare Per Diem
(Destination) Arrival transportation Allowance
e
Official Station to VAN 170.00 1,970.00
Tominobo Terminal
Tominobo Terminal to Jeep 24.00 24.00
Tambo Terminal
1-Aug-22 1,800.00
Tambo Terminal to VAN 250.00 250.00
Bulua Terminal

Bulua Terminal to COA PUJ 100.00 100.00

COA to Bulua Terminal PUJ 100.00 820.00

Bulua Terminal to
2-Aug-22 VAN 250.00 720.00 250.00
Tambo Terminal

Back to Residence Jeep 24.00 24.00

Sub-Total 918.00 2,520.00 3,438.00

* * * Nothing Follows * * *
TOTAL 3,438.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
SARIPA B. MUSOR
Employee

Recommending Approval: Approved by: (Head of Agency)

SAMER C. AMBOLA
OIC-PENR Officer
544.00

350.00
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
Pigcarangan, Tubod Lanao del Norte

Name: KHALID P. AROBINTO Departure Date: December 12, 2023

Position: DRIVER Arrival Date: December 13, 2023

ITINERARY OF TRAVEL
Place to be visited Time Means of Traveling
DATE Departur Fare Per Diem
(Destination) Arrival transportation Allowance
e
7:00 AM Meals 480.00 480.00
12-Dec-23 From Official Station to
Malaybalay
Incidental 320.00 320.00

Meals 400.00 400.00

Back to Station
Incidental 320.00 320.00

* * * Nothing Follows * * *
TOTAL 1,600.00

I certify: 1. I have reviewed the forgoing itinerary Prepared by: (Official/Employee)

2. The travel is necessary to the service
3. The period covered is reasonable
4. The expenses claimed are proper
KHALID P. AROBINTO

Approved by: (Head of Agency)

ABDULRAOF A. ABDULLAH ARNULFO T. OSIO

Chief Technical Service Division OIC-PENR Officer
 CERTIFICATE OF TRAVEL COMPLETED

ARNULFO T. OSIO FEBRUARY 20-21, 2024

(Agency Head) (Date)

OIC-PENR OFFICER DENR, Pigcarangan, Tubod Lanao del Norte

(Designation) (Station)

I CERTIFY THAT I have completed as travel authorized in Itinerary of Travel No. _______________ dated
under conditions indicated below:

X Strictly in accordance with the approved itinerary.

Cut short as explained below. Express payment in the amount of ______was refunded under official
Extended as explained below. Additional Itinerary was submitted

Other deviations as explained below.

Explanation of justification:

Evidences of Travel :

Used tickets

X Certificate of Appearance

Others:

NORJANNAH M. MANGADANG
Employee

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

ARNULFO T. OSIO
OIC-PENR Officer
 Republic of the Philippines
Department of Environment & Natural Resources
PROVINCIAL ENVIRONMENT & NATURAL RESOURCES OFFICER
PENRO, Tubod Lanao del Norte
Tel No.: (063) 227-6070 Fax No.: (063) 227-6070

APPENDIX B

DENR PENRO
(Agency)

CERTIFICATE OF TRAVEL COMPLETED

I certify that I have completed as travel authorized in itinerary of Travel No.

dated February 20-21, 2024 under condition indicated below.

Strictly in accordance with this approval itinerary cut short below excess payment in the
amount of P840.00 refunded under official receipt no. __________ dated 2/20-21/2024
extended as explained below. Additional itinerary was submitted other deviation as explained
below.

Explanation for Justification: See the Attached Approved Travel Order.

Evidence of travel attached to: Certificate of Appearance.

Respectfully submitted

NORJANNAH M. MANGADANG
Official/Employee

On evidence and information of which I have acknowledge the travel was undertaken

Approved by :

ARNULFO T. OSIO
OIC-PENR Officer
 CERTIFICATE OF EXPENSE NOT REQUIRING RECEIPTS CERTIFICATE OF EXPENSE NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017 Pursuant to COA Circular No. 2017-001 dated June 19, 2017
Name of Employee: Norjannah M. Mangadang Employee No.: Name of Employee: Norjannah M. Mangadang Employee No.:
Office/Division: DENR-PENRO LDN Office/Division: DENR-PENRO LDN
Particulars Amount (P) Particulars Amount (P)

3/14/2024 3/14/2024

PENR Office to Tominobo Terminal 130 DBP Iligan Branch to tominobo Terminal 100
Tominobo to DBP Iligan Branch 100 Back to Station 130

Total 230 Total 230

Purpose: To deliver PAYCHECK and other Documents. Purpose: To deliver PAYCHECK and other Documents.

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above 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 goods and services were acquired from parties not issuing receipts. And that I am fully aware that willful falsification
of statement is punishable by law. of statement is punishable by law.
Certified Correct: Noted by: Certified Correct: Noted by:
Signature Signature

Printed Name NORJANNAH M. MANGADANG HERMOSILLA C. FLORES Printed Name NORJANNAH M. MANGADANG HERMOSILLA C. FLORES
 EMPLOYEE OIC-PENR Officer EMPLOYEE OIC-PENR Officer
Date: Date: Date: Date:

CERTIFICATE OF EXPENSE NOT REQUIRING RECEIPTS CERTIFICATE OF EXPENSE NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017 Pursuant to COA Circular No. 2017-001 dated June 19, 2017
Name of Employee: Saripa B. Musor Employee No.: Name of Employee: Saripa B. Musor Employee No.:
Office/Division: DENR-PENRO LDN Office/Division: DENR-PENRO LDN
Particulars Amount (P) Particulars Amount (P)

3/14/2024 3/14/2024

PENR Office to tubod Tominobo terminal 130 PENR Office to tubod Tominobo terminal 130
Tominobo to DBP Iligan Branch 100 Tominobo to DBP Iligan Branch 100
DBP Iligan to Tominobo Terminal 100 DBP Iligan to Tominobo Terminal 100
Back to station 130 Back to station 130

Total 460 Total 460

Purpose: To deliver PAYCHECK and other Documents. Purpose: To deliver PAYCHECK and other Documents.
 Purpose: To deliver PAYCHECK and other Documents. Purpose: To deliver PAYCHECK and other Documents.

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that above 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 goods and services were acquired from parties not issuing receipts. And that I am fully aware that willful falsification
of statement is punishable by law. of statement is punishable by law.
Certified Correct: Noted by: Certified Correct: Noted by:
Signature Signature

Printed Name NORJANNAH M. MANGADANG Arnulfo T. Osio Printed Name NORJANNAH M. MANGADANG Arnulfo T. Osio
EMPLOYEE OIC-PENR Officer EMPLOYEE OIC-PENR Officer
Date: Date: Date: Date:
 CERTIFICATE OF EXPENSE NOT REQUIRING RECEIPTS CERTIFICATE OF EXPENSE NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017 Pursuant to COA Circular No. 2017-001 dated June 19, 2017
Name of Employee: SARIPA B. MUSOR Employee No.: Name of Employee: SARIPA B. MUSOR Employee No.:
Office/Division: DENR-PENRO LDN Office/Division: DENR-PENRO LDN
Particulars Amount (P) Particulars Amount (P)

11/10-11/2022 11/10-11/2022

Official Station to Tominobo Terminal 170 Tambo Terminal to Bulua Terminal 250
Tominobo Terminal to Tambo Terminal 30

Total 200 Total 250

Purpose: To submit Reports at Regional Office, Cagayan de Oro City. Purpose: To submit Reports at Regional Office, Cagayan de Oro City.

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that 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 above goods and services were acquired from parties not issuing receipts. And that I am fully aware that willful
falsification of statement is punishable by law. falsification of statement is punishable by law.
Certified Correct: Noted by: Certified Correct: Noted by:
Signature Signature

Printed Name SARIPA B. MUSOR SAMER C. AMBOLA Printed Name SARIPA B. MUSOR SAMER C. AMBOLA
EMPLOYEE OIC-PENR Officer EMPLOYEE OIC-PENR Officer
Date: Date: Date: Date:
 CERTIFICATE OF EXPENSE NOT REQUIRING RECEIPTS CERTIFICATE OF EXPENSE NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated June 19, 2017 Pursuant to COA Circular No. 2017-001 dated June 19, 2017
Name of Employee: SARIPA B. MUSOR Employee No.: Name of Employee: SARIPA B. MUSOR Employee No.:
Office/Division: DENR-PENRO LDN Office/Division: DENR-PENRO LDN
Particulars Amount (P) Particulars Amount (P)

11/10-11/2022 11/10-11/2022

Bulua Terminal to Region 10 85 Bulua Terminal to Tambo Terminal 250

Region 10 to Bulua Terminal 85 Back to Residence 30

Total 170 Total 280

Purpose: To submit Reports at Regional Office, Cagayan de Oro City. Purpose: To submit Reports at Regional Office, Cagayan de Oro City.

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that 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 above goods and services were acquired from parties not issuing receipts. And that I am fully aware that willful
falsification of statement is punishable by law. falsification of statement is punishable by law.
Certified Correct: Noted by: Certified Correct: Noted by:
Signature Signature

Printed Name SARIPA B. MUSOR SAMER C. AMBOLA Printed Name SARIPA B. MUSOR SAMER C. AMBOLA
EMPLOYEE OIC-PENR Officer EMPLOYEE OIC-PENR Officer
Date: Date: Date: Date:
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