MEDEV MEDICAL DEVVC ES CORP,

MDEVS $21-2890; 822-6376(telfax) / medevmedicaldevices.com

39 Seudi Arabia St., Betterliving. Brgy. Don Bosco, Paranague City, MIM

LIQUIDATION/REIMBURSEMENT FORM
Name JAN LEE MANALO DATE
SUBMITED June 6. 2025
DETAIL S OF CA North Allowance (Pampanga | Baguio)-3D2N w! Cindy AMOUNT TAKEN 12000.00
Nature of Expense
Dae
Customer Company INIORNO Amountin Pesos

TRANSPORTATTION
Hotel- Trulsb JLL TAXI 138-807-25
Trulab- Pakway MULANTAXI 359-856-896
June 5,2025 Parkwsy -BGHMO REZA TOM TAXI 951-876-984
Lunch RHYRANZER RV 00003783 9.0
To Hote! See photo 88.50
LuGh KEICHTAXI 133-202 559
Junea, 2035 Hotel- Bustop{Cinds) MULANTAXI 264-090320 150
To ManilafCinds) Vicory Liner,Inc 000-616 906-00096 637.00
Grab See photo
TOTAL: 1.358.54
MEAL{Bre akfest/Lunc/Dinner)
Apalit Nlex QSR Com 645-383090-0O001
June 4 2025 Bfsst Lunch Dinner Apalit Niex aSR Cop 645-38309000001
GaZ8 RestaUIOnt 251889-7730002
Foam Cofee Roasters 654476069-0500
BaliwagLechon Manok DO0 356 40500030
JHe 5.2025 Bfast Lunch | Dinner Toni and VicoIg Bake 488-076270D000 1.200.00
Kim's Point And Gril 009-878932 0O003
June 6. 2025 Tta Les's Food Specties 479-162-12300000
Bfast ! Lunch Dinner Tea HoUse ReStBUFAnt 1,200.00
413040 380-000
TOTAL 3600.0O
OEP EXPENSE (ex: CHARGE TO OEP- HOSPITAL -MACHINE)

TOTAL 0.00
OTHERS
June 5,2025 Hotef ACEOmdation 2N 456 Hotej 462-156 329-000 8877.00

TOTAL: 8S77.00

PARKING 1,368.54
MEAL 3500.00
OEP Q.00
Hote 1. Must be scGom plshed TMMEDIATELY romdatoeXpenae OTHERS SS77.00
2 Kndly taml za recap nchronologka ordar TOTAL
SUBMITTED BYI NOTEDBY CORRECTEDTBY APPROVED BY EXPENSES
13,845.554
RETURN REFUND)
Enplbyee
(1,84554)
 AL TAXI MULAN TAXI
OPIR.J.LACASAND0LE OPTR.P.BANAKEN RE1A TOM TX
TIN#: 369-856-896
528 LYPN S PI IRISAN BC KC-96 SUNFLONER ALLEY CRUZ
CN#20U5 BL NGCAR B63 C#I4-CAR-931
TEL#: 8922 589D0 TEL#: 0918-2546145
06 05/25 03 24 06/05/25 10:11
Dr iver KPM 214 6Y CHI CI Dr iver RPN:2970 BY:CHI2
Receipt #: Receipt #: 81919
Ser iàl #: ADTM 9è0915 Ser ial #: ADTM-901412
Plate #: 14081 Plate #: AYU-959
9.15 Start Tine: lato # YAA-9,
Start Time: 10:04
End Tinei 09:24 End Time: 10:11
Char ge Tine(hh:mn): Charge Time(hhimn): 00:07 Fnd Tine i
Travelikm): Travel(Kn): 1.9
TOTAL FANE(): TOTAL FARE (P): 62.50 raelKn

LIFRB 24/7 Hotline: 1312 LTFRB 24/7 Hotl ine: 1342

Text/Viber Hotlines: Text/Viber Hotl ines: Te t
8917-550-192 8338 55 1342 0917-550-134218998-550-1342
THIS s E R V E E A o D 3 2 THIS SERVES ASAN OFFICIAL RECEIPT

RHYRANZER RV
R.Tabafunda
256Y Purok 28 KEICH TAXI
Upper Irisan OPTR:B.DELA CRUZ
Baguio city TIN#: 139-202-669
14 BENECO HOUSING ALAPANG LIG
TIN 04-BAGCAR-@40
CP# 09106567373 TEL#: 0917-68885588
RPM: 2690 B6/06/25 09:49
0.R. 00003783 RPM-2735 BY CHI-CHI
Dr iver
Serial # 0051335 Receipt #: 19
Date 2025/06/05 Ser ial #: ADTM-900038
CN# 2023-CAR-165 Plate # YAA-9272
Start Time: 09:40
PLATE NO IAF8152 End Time: 09:44
start 20:42 Charge Time(hh'nm): 08:93
Travel(Km): 1.0
End 20:45 TOTAL FARECP): 54,50
Run(M: S) 3:39
Dist. KM 1.0 LTFRB 24/7 Hotline: 1992
MAX.SPEED 32.0 Text/Viber Hotlines:
Fare PhP 69.50 0917-550-1342/0998-550-1342
THIS SERVES AS AN OFFICIAL RECELe
THIS SERVES AS AN reditatlon#. o29-005423495-000
OFFICIAL RECEIPT
LTFRB 24/7 Hotline:
1342
MachineAccreditation no
039-1617010-40273-24637
SMN
FARE TIME(M:S)
Dist. (KM)
1
ITotNaDEXl fare
2. Total Km
3. Tc
4. Total time
otal for K
5. Total hired
. Totai unittime
7. Total
ired t
PESC
Mrture
 MULAN TX
OPTR.P.BANAKEN
TIN#: 264-030-328
KC95,CRUZ L.J.B
CN.2824-CAR-259
TEL#: 89182596145
06/86/2510:55
Driver RPM:2587
Receipt #: 63041
Ser ial #: ADTM-981568
Plate #: ND0-1077
Start Time: 18:51
End Time: 10:55
Charge Time(hh'mn):
Travel (Km): 1.7
TOTAL FARE(P): 56.50

LTFRB 24/7 Hotl ine: 132

Text/Viber Hotlines:
0917-558-1942/0998-558-132
RECEIPT

THIS SERES AS AN OFFICIAL 0 0 0 2 3 7

Accre ditation#: 0 2 9 - 0 0 5 4 2 3 4 9 3-
 VICTORY LINER, INE.
Marcoville Session Road Area 2600
Baguio City Benguet
Philippines
VAT REG. TIN O00.616-906-00006
(VAT EXEMPT)
PASSENGER SINVOICENO:

A 0662016 B
PASSENGER'S INVOICE
DATE OF PURCHASE
PASSENGER'S NAME:
Address:
TIN NO.
SC/PWD/NAACI
MOV ID No.
Signature:

CONDUCTOR'S COPY
BUS NO.:
SEAT NO:N
Nature of Service: Nature of Service:
FROM: TO: 4
PAYMENT RECENED IY:
TOTAL
SIGNATURE VE: PRINTED NAME
Telie/ Authai ke Representatve
AMOUNT DUE:

FOM OF PAYMENT
CANCELLED TFR CASH CARD

PARTICULARS
DATE TIME SEAT NO.
REBOOKING/ REVALIDATED DY:

PASSENGER'S INVOICE NO:

A0662016 B
1200 Bkts. (100x3) Nos. A0660001 - A0780000
BIR Authority to Prnt No.: 125AU20250000002732
Date Issued April 25, 2025
TAX
POÇUMENT IS NOr VA p FOR CUAMOF INPUT
7:43 l 9 9)

6 Jun 2025, 6:14 PM

Jimmy Bayatan Escabillas

Cash

Personal

Total P221.00 >

UNIVERSITY
HILLS
LINTAWAK

looBMops
Standard

Ayala Malls Cloverleaf Main Entr...

AngDating Daan - Baesa

 APALIT NLEX QSR CORPORATION
Total Service Sation, Km 55 North Luzon Expressway (Noth Bound). APALIT NLEX QSR CORPORATION
Sucad 2016, Apalt, Panpanga, Philippines Tdal Serves lation, Km 55 torth Lzon Erpressway (tioth Bound,
VAT Reg. TN: 645-383-090-00001 Swad 2016. Apalit, Pampanga, Phitipoines
VAT Rog TIN 645-383090-00001
VAT INVOICE N9 2189
VAT INVOICE N9 2190
Date

Addressh
Bus Style/Name:
Bus. Style/Name:
SCPND ID No.. Cardho der's Sgnature
SC/PWD I0 No.: Cardhoider sSgnature.
aTY. TENS U-Price AMOUNT
OTY UM TENS
AMOJNT

Tota Saies (VAT Incusive)

Le3s VAT |Tota Sales (VAT Inclusvej)
Less VAT
Tota
Toa
Tota Due
Les.cWD DBCOurt
|Total Due
Lecs: W/Tax
Less: W/Tax
Amount Due Amount Due

vatabie Sales
Vatable Sales
Zero-Rated Sales
Zero-Rated Sales
POS No VAT-Exempt Saes
POS No. |VAT-Exempt Sales
TR NO 16MEGVAT Amout TR NO, 6USOVAT Amourt
ode af Payment/) |Issued by: ssued by:
Mode of Payment!/)
Cash Cash
Chedk
Check
. No. (Print Name &Sign) Ch. No. (Print Name &Sign)
SO Bts 513 001-2500
BRAorty to Prit No 21BAU20240000004957 50Pklts, (5013) 001- 2500
BIR Authority to Print No 218AU20240000004957
Date lssued: April 19. 2024
Date lssued: April 19, 2024
BLUE ANGEL PRINTING PRESS BLUE ANGEL PRINTING PRESS
Barca 1s Plaride Buiacan Prirter's Aaedtztion No: 25AMPZAsOOO000050 Banga 1st, Plaridel. Bulacan Prirter's Accsdiaton No: 25AMP202AGOSO000050
TIN. 141-755-277-00D00 Non-VAT Date isssed: 01-26-2024 TIN: 141-755-277-00000 Non-VAT Date Issued 01-26-2024

FUAM COFrEE ROASTERS OPC SERVICE

GANZA RESTAURANT Dperated by: FOAM COFFEE ROASTERS OPC INVOICE
ZENADAB CATING-Prop SERVICE INVOICE VAT Reg. TIN: 664-476-069-00000
VAT Rez TIN: 261-889-773-00002

Burnham Foottall Grounds

LerardaBurnham-Kisad
1212
Foam Café 15 Bukaneg Legarda-Burnham-Kisad,
2600 City of Baguio, Benguet Philippines 0961
2600 Bagio y OCASH SALES DCHARGE SALES
Ç-(-25
CASH SALES SOLD T0:
HARGE SALES
Date

SOLD to:
Registered Narme 1edes iedcal bentesQroetA
Registered Name Business Address : D A OAERAAA4
TIN 2ce30 2.6 ParsN Chty
Business Address Dn . Received the amount of:
Unit Price Amount
Bem Desceription / Name of Serice Ouantity

Item Description/ Quantity Unit Price Amount

Nature of Service
.

Total Sales(VAT Inclusive)

VatatleSales
Less: VAT
Vat
Amount: Net of VAT
Zero Rated Saies
Less Discount: SC/PWD/
VATabie Exermpt NAAC/MOV/ SP
Saies
Add: Vat TOTAL SALES
Received the amount of: VAT nçlusve)
Les VAT
VATable Sales
VAT Armount: Net of VAT
less D oun
Less: Withholding Tax
Lero Rated Sales |5C/PWD/NAAC MOV/SP]
Add: VAT
VAT-Exempt Sales
TOTAL AMOUNT DUE Less: Withholding Tax

SC/PWD/AAC/MOV/
SOLO PARENT ID No.
By CIPWDNatutg TOTAL AMOUNT DUE

Sc/Pwo/NAAC/MON/
Cashier/Authorlzed Sgnature Form ol PaymentJCash JCheck
Segnat:e Bank Dale
Pired y CRO Pelg Burdcg CPH8ES814 Check No Cashier /Authorized Representative
012n INTED Y
6CN OUBAARAKOO4762*Daespud RATP NO. OCN. 008AU2024000000737
ed 01ras
NaldWrelgh: wakighPng PiePdD a t e ksed: 12/06/24
KCS2170 211T10046.B00-4100Bts (50x21 SN: 0001 -1,000
 TONI ANDVICTORIA BAKERY
Operated by LeanFord Corprton
VAT Reg TIN 438-71627-00O00 RESTAUN Philpnes ,2025CoNAy ANs pesos ReCpasrhi/Anutaovrized
7335N?
0CORPATIN 9-87.32 JDeat5e Barco,
26 Mabin Sreet 289 Baguo Cty.
Bengug Phiippies
SALES
INVOICE N? 900322 Benguet,
GRIL Baguio DeCA
DCASH SALES
City,
hanls
O CHARGE SALES
BALIWAG LECHON MANOK,
Chagua or Ces S, Aberas-Zarota INC.iek SOLD TO:
o
sum
the
f
(Ax0) 2805 BaO Cy Berguet eyong-Chugu
Pprs8
MEOEV MEOOAL oEVIOES oRp
260 FO D
VAT Fe TiN:000-856-105-00090 Registered Name o
ad re8
21tNIP0 8
TIN
SALES NOCE 203-088 302 o0000 at
N? 53204
A Business Address
RND payment
POINT SesionOperatd INVÚTCE" ORFECI APTL om/sDev 302-ot0
TINSC-TH: 2aiOsCAFD D Na.
CoN
Hem Description
Nature of Service

oCo PAANAQUE CTY

Quantity Unit Cost/
Pice Amount AND ArRoeaa,d by: TIN
eDICAL and
for
Busirzss Sie:
Address: DonSeeny Ch erns:
CATY. DESCRIPTION

SCPWD Signatue:
UIT PRCE| AONT
CtocoLATE ICFB0
CHO CO CAEM AFF 2 90
parti l/u Slgnalure
style
of
20
BuildngOwned busines )In
Acreltaion
KIM'S Manhan SALES REC VED -243o5$
&
No
|
TIN
the
enga ed
in
3SI Sr.
TIN
Cilizen
ID
OSNo.
CAPWD
NAnterIDa'/sasute
VATbesgt Saes 102 with P
VAT ZA Pss
VÁT ATK At VAT
7OTALAOUATDIE
Rsceived the ebove goods in
fol wing:AMOUN 32-4/ POFAFYMOENRT:M LI
CHECK
O08AU24.7
VATable Sales
169 Sts, (5 9961A6SSESA g9sd order and condition. Total Sales (VAT Inclusive)40%.2
VAT
48.71
Moa-V Ros T 215-8-642-40300

By
Cashierlaei PepseSsniaie
Pinkste Aeratksn #a.
Zero-Rated Sales
VAT-Exempt Sales

Less: VAT
Amount: Net of VAT
Less: Discount
Setlment
the
of
Inclusive) ee:SCD/PiWscNoDunt (RUO-218)
(SC/PWD/NAACIMOV/SP] INo.
nvoice
OReceived the amount of
Add: VAT
Less: WithHolding Tax (VAT
Sales Less
Wthoding
Tax
Due
Amount SalVATaebsle
Sale
SalExVATemepst Rated
No
(50)
024
TOTAL AMOUNT DUE
VSS .00 In VAT Zero SalToteasl
Authorized Representative SC/PWD/NAAC/MOVI
Solo Parent ID No.:
Tolal Total
D
Les: VA
CASH s.
BIA AUTHORITY TO PRINT NO. BAU20240000000 N
DATE ISSUED NOVEMBER 08, 2024
APPROVED SERIES: 0001- 1000 20 BKLTS (2X)
SC/PWDINAAGIMOVI
 TEA HOUSE RESTAURANT & BAKESHOP
Operated by: TEA HOUSE CORPORATION
87 Antipolo Bldg., Session Road,
CLOMDATI RCeapshri!An4tovzed o.08MP2A19creditalns
VAT Reg. TIN: Baguio City
413-040-380-000
Tel. No.: 442-8757
SERVICE INVO0CE
OFICLALREEEIPT Nº 202512 A
2025 SCRAN
TITA LEA'S FOODSPECIALTIES
Lea P. Paez - Prop.
Non-VAT Reg. TIN: 479-162-123-00000
Old Postal Office Bilding, Salud Mitra, 2600 Baguio City, Benguet, Philippines with TIN
Received from Meday Medse
-03NHd address at don Bse, ParengA
POSCcORFATION
-JUNE style
5.
O bu sines
of_
HNDRCD
SALES
INVOICE
DCASH SALEs
SOLD TO:
O CHARGE SALES
Registered Name :EDtY MUTCAL btvicts 6RPORATTOV
Date:

N° 024715
6-6-2

Cihy
the sum of
(P 3G00
aty

engaged in the business style of

)in full/partial payment for
Articles Unit Price

pesos
Amount
H4OT5E6L 462-15390
City
Baguio
Date
0 9102 DYCE
the
S
ElHT oIEL
enga ed vAND payment
DON in
for
atls ue
TIN
Business Addresss
209-0YÝ-36.00000
Don toso, ParaFaau
cunas Road,
Legarda TIN; ad res of_
partil/fu By:
Buidng. Registraon
Che
MEDICAL and
ROMEFC2I51PA|T0L9 02-U617_
Item Description/ Unit Cost/
Nature of Service Quantity PHce Amount
Elb
N9 of
J.In Signature
LMEDEV 0Z-0R- VAR MAQVE
156 VAT sum
the
C
, hi
pesos(P_
ID
OsNo.
CAPWD
from St.
TIN
Citlzon
Rec ived
Exempt Sales
Sales Subject to
Percentage Tax
Total Sales
Less: Discount
IrscPwDINAACIMOVISPI
Tota Seles (VAT Incd.)
fol wing. Amount 9.810
TIN
with
tAUhZI2054o
|Casheck
Received the amount of Less: VAT
Less: WithHolding Tax
VATable Sales Amount: of Net VAT
TOTAL AMOUNT DUE
T902.3I74N50
SCPWDINAACIMOVI VAT-Exempt Sales Less: SCIPWD Dics
THIS DOCUMENT IS
NOT VALID FORCLAIM
OF INPUT TAX."

Solo Parent ID No.:

SCPWDINAACIMOVI
Signature:
Zero Rated Sales
VAT Amount
Amount Due setlment Particular
the
of
bengl Sakes
Saes
VAT leo
Rted of
Pay
Form
10000
5001-
(50.2)
Press
Pining
O:ber
BIR
aIR AUHORIIY TO PRINT NO. 008AU20250000O02674 Add: VAT
VATAourt
10 Date Pádted
8, Z025 By n
Bkis by
APPROVED SERIES. 25500 20 BKLTS. (50 X2) TOTAL AMOUNT DUE
PRINTERS ACCREDITATION NO:
O08MP20190000000O08
DATE ISsSUED: JAN, 31, 2o19
4000 Bklts.
BIRAUTH. top r i o N . 2 5 0 0 1 A - 2 2 5 0 0 0 A
:008AU20230000004935
Date lssued: 09-20-23
kaGl-VISION PBNTING PRESST Authorized Signature
TIN: 185-749-074-000