Forms New

INSPECTION AND ACCEPTANCE REPORT
Entity Name: Department of Social Welfare and Development Fund Cluster: _________
Supplier: KS BEE CATERING SERVICES IAR No.:____________

PO No/Date: 18-07-0283/ July 13, 2018 Date: ______________
Requisitioning Office /Dept.: RJJWC Invoice No: ________
Responsibility Center Code: ______________________ Date: ______________
Stock/Property No. Description Unit Quantity
1 1 meal and 2 snacks pax 60
INSPECTION ACCEPTANCE
Date Inspected: __________________________ Date Received:
Inspected, verified and found in order as to Complete

quantity and specifications
Partial (pls. specify quantity)
_______________________________________
Inspection Officer/Inspection Committee
RESTITUTO B. MACUTO
Noted by: Regional Director
ALICE VIASON
Chairperson of Inspection Committee
Republic of the Philippines
REGIONAL JUVENILE JUSTICE AND WELFARE COUNCIL
DSWD Field Office VIII Compound, Magsaysay Boulevard, Tacloban City, Leyte
(053) 321-2040; email add: rjjwc8@jjwc.gov.ph
DISTRIBUTION SHEET
for T-shirt
6th JJW Consciuosness Week Celebration
T-shirt Sizes
No. Name Address Signature
Small Medium Large
1
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MONTHLY WORKPLAN
for the month of November , 2013
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Prepared by: Recommending Approval:

Appendix 32
DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT Fund Cluster :

Field Office VIII
Date :
DISBURSEMENT VOUCHER DV No. :
Mode of MDS Check Commercial Check ADA Others (Please specify)

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee WILFREDO O. ESTORNINOS, ET.AL
Address Tacloban City
Particulars Responsibility MFO/PAP Amount
Center
TRUST FUND
RJJWC
24000
To payment of emoluments for the period Jan. 25, 2018, June
Amount Due 24,000.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.
MARLENE L. KAHANO
SWO V/OARDA
Printed Name, Designation and Signature of Supervisor
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)

S Supporting documents complete and amount claimed
proper
Signature Signature
Printed
Printed Name CHRISTOPHER I. BACASON Name RESTITUTO B. MACUTO
Regional Accountant Regional Director
Position Position
Head, Accounting Unit/Authorized Representative Agency Head/Authorized Representative
Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account
ADA No. : Number:
Date : Printed Name: Date
Signature :
Official Receipt No. & Date/Other Documents
LIQUIDATION REPORT No.
Date:
REGIONAL JUVENILE JUSTICE AND WELFARE COUNCIL Responsibility Center:
Field Office No. VIII Code
Magsaysay Boulevard, Tacloban City
PARTICULARS Amount
To liquidation of FUND TRANSFER for the implementation of projects

and program of Regional Juvenile Justice and Welfare Council as per
supporting papers are hereto attached in the amount of
…………………………………………………..
Php 246,260.55
Total Amount Spent

Php 246,260.55
Amount of Cash Advance Per DV No. DTD
Php 2,005.00
Amount Refunded Per OR No.
Amount to be Reimbursed
Php632.50
A Certified: Correctness of B Certified: Purpose of travel/Cash C Supporting documents
the above data advanced duly accomplished. complete and proper
NESTOR B. RAMOS LETICIA T. DIOKNO MARY AGNES S. PUSAY
Claimant Immediate Supervisor Head Accounting Unit JEV No.
August 3, 2018
TRAVEL ORDER
No. RJJWC 031
Series of 2018
To:
AGNES E. BUGAL
Social Welfare Officer III
PLACE/S DATE/S TRANSPORTATION
Ormoc City August 20, 2018 PUV/PUJ

Ormoc City August 28-31, 2018 PUV/PUJ
Purpose/s
1) Attend Team Building Activity

2) Assist Barangay Protocol Workshop
It is understood that a report shall be submitted upon completion of this travel

together with Certificate of Appearance from each place and documentary evidence of travel.
Approved:
RESTITUTO B. MACUTO
Head of Office
Duly Authorized Representative
esentative
DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
Field Office VIII, Magsaysay Boulevard
Tacloban City
SUPPLEMENTAL PROJECT PROCUREMENT MANAGEMENT PLAN (SPPMP)

CY 2013
Name of Office/Bureau/Service/Unit: Office of the Asst. Regional Director for Operations

Name of Project:
Total Budget Php7,000.00
Source of Fund:
Contract ProcurementTime Schedule for each

Estimated Budget for
No Type of Contract Packages Method to be Procurement Activity
General Component of
Qty. Unit adopted 1Q 2Q 3Q 4Q the Contract
1 mobile pedestal (with lock, 2 Bidding/PS/LS - - - 2 Php7,000.00
3 drawers and gray)
xxxxxx nothing follows xxxxxxxxxx
GRAND TOTAL Php7,000.00
Prepared by: Noted by: Approved by:
JOANNA A. BERINO NESTOR B. RAMOS REMIA T. TAPISPISAN

Administrative Aide IV OIC Asst. Regional Director for Operati Regional Director
Budget for
mponent of
PISPISAN
May 11, 2018
Date
TRAVEL ORDER
No. RJJWC 017
Series of 2018
Subject: AMENDMENT
Travel Order No. 16 , series of 2018 is hereby amended as to :
√
x change the date of conduct of
/
change the venue of
include as among ther participants to

/
Training/seminar/conference/etc.
1.) To Follow-up compliance of CLJIP

2.) Plan for BCPCs workshop in development of CLJIP
3.) Follow-up compliance requirements for BPA
Instead of It should be:
Date Date
May 15-17, 2018 May 16-18, 2018
Place Place
PSWDO, Southern Leyte

CSWDO Maasin
Official(s) staff to be included:
AGNES E. BUGAL, SWO III
Approved by:
RESTITUTO B. MACUTO
Regional Director
Appendix 14
BUDGET UTILIZATION REQUEST AND STATUS Serial No. : ___________________

DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT Date : _______________________
Field Office VIII Fund Cluster :_________________
Payee LIBCAP SUPER EXPRESS CORP.

Office
Particulars MFO/PAP UACS Object Code/

Expenditures Amount
Responsibility C
To request budget utilization of Delivery RJJWC Trust

charges for the dates of:
Fund
May 3, 2018 75.00
May 11, 2018 75.00
May 15, 2018 75.00
June 7, 2018 105.00
as per attached supporting papers

amounting to One Hundred Ninety Pesos
and Forty Centavos
Total 330
B.
A. Certified: Charges to appropriation/budget necessary, Certified: Budget available and utilized for the
lawful and under my direct supervision; and supporting purpose/adjustment necessary as indicated above.
documents valid, proper and legal
Signature ____________________________________ Signature : _______________________________

Printed N RESTITUTO B. MACUTO Printed Name: JASMIN D. BULGADO
Position REGIONAL DIRECTOR Position : AO IV/HEAD, BUDGET
Head, Requesting Office/Authorized Representative
Head, Budget Division/Unit/Authorized Representative
Date _______________________________ Date : ____________________________
:
C. STATUS OF UTILIZATION
Reference Amount
Balance
BURS/JEV/RCI/ Utilization Payable Payment Not Yet Due Due and Demandable
RADAI/RTRAI No.
Date Particulars (a) (b) (c) (a-b) (b-c)
Demandable
DSWD TRAVEL ORDER FORM NO. 91
Revised-February, 1998
April 6, 2015
CONFIRMATION OF TRAVEL
No. ___________
Series of 2015
To:
ORVILLE C. BERINO
AO II/OIC Head, AU
PLACE/S DATE/S TRANSPORTATION
Federal Phoenix Insurance Company, March 28, 2015 taxi

Makati City
Purpose/s
Disccussed with account officer of insurance company the additional requirements

for the insurance claims of the FO flooded vehicles.
It is understood that a report has been submitted upon completion of this travel together with
Certificate of Appearance from each place visited and other documentary evidence of travel.
Recommeding Approval:
MARLENE L. KAHANO
SWO IV/OIC ARDA Approved by:
NESTOR B. RAMOS
OIC Regional Director
REQUISITION AND ISSUE SLIP
Department of Social Welfare and Development

Regional Office VIII, Tacloban City
Entity Name: ORD Fund Cluster :
Division ORD Responsibility Center Code :

Office DSWD FO8 RIS No. :
Requisition Stock Available ? Issue

Stock No. Item Description Quantity Yes NO Quantity Remarks
Unit
pc Mouse, Optical 2
Cart Ink cart, Epson(T6641)Black 24
Cart Ink cart, Espon(T6642)Cyan 8
Cart Ink cart, Epson(T6643)Magenta 8
Cart Ink cart, Epson(T6644)Yellow 8
pack Battery dry cell AA 2pcs blister pack 8
can Air Freshener aersol 280ML/150 g min 24
Bot ALCOHOL ethyl 68%-70% scented 500ml (5ml) 54
pc Clearbook 20 transparent pockets for legal size 2
pc Corresction Tape film base type UL 6m min 250
box Data file box made of chipboard w/ closed ends 6
box ENVELOPE Documentary for legal size docs 1
pc ERASER plastic/rubber for pencil draft/writing 6
pack Folder tag board for legal size documents 8
pc Marker permanent bullet type BLACK 12
pc Marker permanent bullet tpe BLUE 12
pc Marker permanent bullet type RED 12
pad Note Pad stick on 500x76mm (2"x3"')min 12
pad Note Pad stick on 76mmx76mm(3"'x3'')min 12
pad Note Pad strick on 76mmx100mm(3''x4')min 12
box Paper clip vinyl/plastic coat length 32mm min 6
box Paper clip vinyl/plastic coat length 48mm min 6
ream Paper Multi purpose (COPY) A4 70 gsm 80
ream Paper Multi purpose (COPY) Legal 70 gsm 54
box Pencil Lead Eraser wood cased hardness HB 2
pc Philippine National Flag 1
box Rubber band 70mm min lay flat length (#18) 12
pc Sign pen Black Liquid/gel ink 0.5 mm needle tip 200
pc Sign pen BLUE liquid/gel ink o.5mm needle tip 300
pc Sign pen RED liquid/gel ink 0.5mm needle tio 50
pc Stamp pad ink purple or violet 6
Purpose/Remarks CY 2018 SUPPLIES
Requested by Approved by: Issued by: Received by:
Signature
Name MARLENE L. KAHANO CLARITO T. LOGRONIO PAUL ALBIA BERNARDITA MASCARINAS
Designation SWO V/ARDA for Admin. OIC-DC,Admin. Division AA II AAIII
Date
REQUISITION AND ISSUE SLIP

Entity Name: ORD Fund Cluster :
Division ORD Responsibility Center Code :

Office DSWD FO8 RIS No. :
Requisition Stock Available ? Issue

Stock No. Item Description Quantity Yes NO Quantity Remarks
Unit
pc Stam pad FELT bed dimension 60mmx100mm min 2

box Staple wire standard (26/26) 12
roll Maskingn tape width 48mm (1mm) 5
roll Tape Packaging width 48mm (1mm) 6
roll Tape Transparent width 48mm (1mm) 24
pack Toilet tissue paper 2-plys sheets 150 pulls 36
tube Cutter Blade for heavy duty cutter 6
pc Cutter knife for general purpose 3
pc Dating and Stamping machine heavy duty 2
pc Scissors symmetrical blade length 65mm min 2
xxxxx
Purpose/Remarks CY 2018 SUPPLIES
Requested by Approved by: Issued by: Received by:
Signature
Name MARLENE L. KAHANO BRIGIDA D. ESPEJO PAUL ALBIA BERNARDITA MASCARINAS
Designation SWO V/ARDA for Admin. Chief Administrative Officer AA II AAIII
Date
CERTIFICATION
To whom it may concern:
This is to certify that Mr./Ms. JEEKERIN OSONIO has appeared in
Ocean View Hotel and Water Spa, Tolosa Leyte on July 17-19, 2018
(date of appearance)
for the CAR and CICL Registry
(state the purpose and the area/place)
It is further certified that during the visit/stay of the above mentioned name, this office;
Please affix your signature on

appropriate box Particulars Inclusive Date
Did not provide hotel /lodging

and food and meals
Provided the following:

Hotel/Lodging
Accommodation
Meals
Breakfast
Lunch
Dinner July 17-19, 2018
This certification is issued upon request of the interested party for whatever purpose it may
serve.
Done in Oceanview Hotel & Water Spa,Tolosa Leyte on July 19, 2018
(place of issue) (date of issue)
RESTITUTO B. MACUTO
Regional Director
Note:
This certification shall be issued to officials or employees on official travel in accordance to paragraph 1.3 of Memorandum Circular
No. 37, series of 2004 on Austerity Measures and shall be one of the bases for collecting allowance travel expenses.
Date
CERTIFICATE OF APPEARANCE
This is to CERTIFY that

(Name and Designation)
of was in
(Address) (Place visited)
on
(Date of Appearance) (Date of Appearance)
Purpose:
RESTITUTO B. MACUTO
RJJWC Chair
Date
This is to CERTIFY that

(Name and Designation)
of was in
(Address) (Place visited)
on
(Date of Appearance)
Purpose:
RESTITUTO B. MACUTO
RJJWC Chair
Focus Group Discussion
July 26, 2017
Bahay Pag-asa, Alang-alang, Leyte
ATTENDANCE SHEET
No. Printed Name Age Address Signature
10
11
12
13
14
15
16
17
18
19
20
Writeshop on drafting of Comprehenisve Local Juvenile Intervention Program (CLJIP)
Alang-Alang, Leyte
August 6, 2018
ATTENDANCE SHEET
Morning Afternoon
No. Printed Name Position Contact Number/Email Office/Address Signature
Address
IN OUT IN
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
CLJIP)
Afternoon
Signature
OUT
appendix 45
ITINERARY OF TRAVEL
Entity Name: Department of Education
Government Center, Palo, Leyte
Fund Cluster: No.:
Name : ATTY. ELEANOR CALUMPIANO Date of Travel: May 23-27, 2017

Position : Attorney II Purpose of Travel:
Official Station: Attended the Training of Trainors on the Enhancement and
Finalization Of CRJIP.
Date Places to be Visited Time Means of Transportatio Total

n Others
(Destination) Departure Arrival Transportation Amount
May 23, 2017 residence - DZR Airport 4:30 a.m 5:05 a.m MCH 250.00 - 250.00
terminal fee 150.00 - 150.00
DZR Airport - NAIA Airport 6:15 a.m 7:35 a.m plane -
NAIA Airport-venue 8:05 a.m 10:45 a.m RPV - 240.00 240.00
May 24-26, 2017 still at the venue 480.00 480.00
May 27, 2017 venue - NAIA Airport RPV -
NAIA Airport-DZR Aiport 4:25 a.m 5:45 a.m plane -
DZR Airport - residence 6:15 a.m 7:45 a.m MCH 250.00 240.00 490.00
xxxxxxxxxxxxxxxxx nothing follows xxxxxxxxxxxxxxxxxxxxxxxx
Grand Total Php1,610.00

I certify that:
(1) I have reviewed the foregoing itinerary. Prepared by:
(3) The period covered is reasonable.
(4) The expenses claimed are proper. ATTY. ELEANOR CALUMPIANO
Attorney II
Approved:
RAMIR B. UYTICO, ED.D., CESO IV

Regional Director, DepED RO 08
appendix 45
ITINERARY OF TRAVEL
Entity Name: RJJWC Regional Office 08

Tacloban City
Fund Cluster: No.:
Name : JOANNA A. BERINO Date of Travel:

Position : Administrative Assistant III Purpose of Travel: To facilitate purchase order, followed-
Official Station: RJJWC delivery of supplies and materials, assisted in the provision of
technical assistanct on R.A 9344 as amended
Date Places to be Visited Time Means of Total

Transportation Others
May 2, 2017 FO - Borongan, E. Samar 12:30 p.m 4:30 p.m RPV - 240.00 240.00
May 3-4, 2017 still at Borongan, E. Samar 320.00 320.00
May 5, 2017 Borongan, E. Samar - residence 8:00 a.m 12:40 p.m PUV 350.00 240.00 590.00
May 18, 2017 FO - EDS 9:30 a.m 9:45 a.m MCH 8.00 8.00
EDS - FO 11:30 a.m 11:55 a.m MCH 8.00 8.00
May 19, 2017 FO - Leyte Paperworld 1:25 p.m 2:35 p.m MCH 8.00 8.00
Leyte Paperworld - EDS 2:40 p.m 3:10 p.m MCH 8.00 8.00
EDS - FO 3:15 p.m 3:30 p.m MCH 8.00 8.00
May 30, 2017 FO - DSWD Ext. Office 3:20 p.m 3:30 p.m MCH 8.00 8.00
DSWD Ext. Office - FO 3:45 p.m 3:50 p.m MCH 8.00 8.00
June 2, 2017 FO - DSWD Ext. Office 9:45 a.m 9:55 p.m MCH 8.00 8.00
DSWD Ext. Office - EDS 10:05 p.m 10:45 p.m MCH 8.00 8.00
EDS - FO 10:50 p.m 11:15 p.m MCH 8.00 8.00
May 22, 2017 FO - DZR Airport 2:30 p.m 3:20 p.m RPV - - -
terminal fee 150.00 150.00
DZR Airport-NAIA Airport 5:55 p.m 7:30 p.m plane - - -
DZR Airport-Mandaluyong City 8:34 p.m 9:30 p.m GrabTaxi 213.00 240.00 453.00
May 23-24, 2017 still @ the venue (Mandaluyong City) 320.00 320.00
May 25, 2017 Mandaluyong City-NAIA Airport 5:30 a.m 8:30 a.m taxi 183.50 183.50
NAIA Airport-DZR Airport 11:00 a.m 12:25 p.m plane - - -
DZR Airport-terminal 1:30 p.m 2:40 p.m MCH 200.00 - 200.00
terminal fee - residence 2:45 p.m 4:40 p.m PUV 50.00 240.00 290.00
June 4, 2017 residence - DZR Airport 2:30 p.m 3:40 p.m MCH/PUJ 200.00 200.00
terminal fee 150.00 150.00
DZR Airport - NAIA Airport 6:00 p.m 7:20 p.m plane
NAIA Airport - Quezon City 7:40 p.m 8:30 p.m Taxi (c/o SWO III Bugal)
June 5-8, 2017 still @ the venue(Quezon City) 640.00 640.00
June 9, 2017 Quezon City - NAIA Airport 12:30 p.m 3:10 p.m Taxi (c/o SWO III Bugal)
NAIA Airport-DZR Airport 3:55 p.m 5:15 p.m plane
DZR Airport - terminal 5:20 p.m 5:45 p.m MCH 200.00 200.00
terminal - residence 5:50 p.m 6:10 p.m PUV 50.00 240.00 290.00
xxxxxxx nothing followsxxxxxx

I certify that:
(2) The travel is necessary to the service.
(3) The period covered is reasonable. JOANNA A. BERINO
(4) The expenses claimed are proper. Administrative Assistant III
AGNES E. BUGAL Approved:

Social Welfare Officer III RESTITUTO B. MACUTO
Regional Director
appendix 45
appendix 45
ITINERARY OF TRAVEL
Entity Name: DSWD-RJJWC

Fund Cluster: No.:
Name : MS. LOLITA ARELLANO Date of Travel: May 23-27, 2017

Position : Program Area Manager Purpose of Travel:
Official Station: Plan Phils., Int'l. Attended the Training of Trainors on the Enhancement and
Finalization Of CRJIP.
Date Places to be Visited Time Means of Transportatio Total

n Others
May 18, 2017 DZR Airport to NAIA Airport 6:10 a.m 7:40 a.m plane (c/o - - -
PLAN)
Terminal fee 150.00 150.00
May 23, 2017 temporary residence to venue 6:00 a.m 7:45 a.m Taxi 292.00 240.00 532.00
May 24-26, 2017 still at the venue 480.00 480.00
May 27, 2017 venue to temporary residence 10:00 a.m 1:30 p.m taxi 190.50 240.00 430.50
xxxxxxxxxxxxxxxxx nothing follows xxxxxxxxxxxxxxxxxxxxxxxx

I certify that:
(3) The period covered is reasonable.
(4) The expenses claimed are proper. LOLITA ARELLANO
Program Area Manager
Approved:
NATIVIDAD SILORIO
Area Manager
Appendix 47
CERTIFICATE OF TRAVEL COMPLETED
Entity Name: DSWD FO 08 Fund Cluster:

Tacloban City
(Agency Head) (Station)
I HEREBY CERTIFY that I have completed the travel authorized in Travel Order/Itinerary of Travel
No. dated under conditions indicated below:
Strictly in accordance with the approved itinerary.
Cut short as explained below. Excess payment in the amount of Php ________________________ was
was refunded under O.R No._________________________________________________________
Extended as explained below. Addiitonal itinetary was submitted.

Other deviation as explained below.
Explanations or Justifications:
Flight on the May 22, 2017 (Tacloban-Manila) were moved twice, from
4:20 p.m to 5:20 p.m then at 5:55 p.m due to airport congestion.
Evidences of travel attached hereto:

certificate of appearance, travel order, rer, boarding pass, e-tickets
receipt
Respectfully Submitted :
JOANNA A. BERINO
Administrative Assistant III
On evidences and information of which I have knowledge, the travel was actually taken.
AGNES E.BUGAL
Supplier EDS IAR No.

PO No. Date August 16, 2017 Invoice No. Date
Requisitioning Office /Dept. RJJWC
Item No. Unit Description Quantity
5 pc. Brother, Toner TN 261- Black 1

6 pc. Brother, Toner TN 261- Cyan 1
7 pc. Brother, Toner TN 261- Magenta 1
8 pc. Brother, Toner TN 261- Yellow 1
xxxxxxxxxxx nothing followsxxxxxxxxxxxxxxxx
Date Inspected: Date Received :
Inspected, verified and found OK Complete

as to quantity and specifications Partial
AGNES E. BUGAL
Inspector SWO III
Supplier HANZ GRAPHICS & DIGITAL IMAGING CENTER IAR No.

PO No. 18-05-0161 Date May 23, 2018 Invoice No. Date
1 pcs Lanyard (with logo, plastic buckle release, royal blue, 1 inch) 75

AGNES E. BUGAL
Inspector SWO III
Supplier Oceanview Hotel and Water Spa IAR No.

PO No. 17-07-0362 Date July 17, 2017 Invoice No. Date
Requisitioning Office /Dept.
1 pax Board and lodging with function room 60

August 30, 2017
rjjwcrjjwcrjjwcrjjwc

DAISY MAE D. CERA AGNES E. BUGAL

Inspector SWO III
Supplier Hotel Don Felipe IAR No.

PO No. 17-07-0363 Date July 17, 2017 Invoice No. Date
1 pax Board and lodging with function room 60

xxxxxxxxxxnothing followsxxxxxxxxxxx

AGNES E. BUGAL
Inspector SWO III

Supplier Ladera Artspot & Advertising IAR No.

RSO No. RJJWC-004 Date 13-Nov-17 Invoice No. Date
1 pc tarpaulin (8x16 ft) 1

2 pc tarpaulin (4x8 ft) 1
xxxxxxxxxxnothing followsxxxxxxxxxxx

AGNES E. BUGAL
Inspector SWO III

Supplier IAR No.

RSO No. RJJWC-004 Date 13-Nov-17 Invoice No. Date
1 pax Glass plaque 3

2 pcs Illustration Board (1 whole) 10
3 pcs Oil pastel paint @ 12 pcs 10
4 doz balloons (with printing, blue, yellow, white) 7

AGNES E. BUGAL
Inspector SWO III
PURCHASE REQUEST
Field Office VIII, Tacloban City
Entity Name : ORD Fund Cluster
PR No. : Date : August 10 , 2018

Responsibility Center :
Stock/Prop
erty No.
Unit Item Description Quantity Unit Cost Total Cost
pc Mouse, Optical 2 140.39 280.78

cart Ink Cart, Epson(T6641)Black 24 264.99 6359.76
Cart Ink Cart, Epson(T6642)Cyan 8 264.99 2119.92
Cart Ink Cart, Epson(T6643)Magenta 8 264.99 2119.92
Cart Ink Cart, Epson(T6644)Yellow 8 264.99 2119.92
pack Battery dry cell AA 2pcs blister pack 8 20.28 162.24
can Air Freshener aersol 280ML/150 g min 24 88.69 2128.56
Bot ALCOHOL ethyl 68%-70% scented 500ml (5ml) 54 49.73 2685.42
pc Clearbook 20 transparent pockets for legal size 2 40.47 80.94
pc Corresction Tape film base type UL 6m min 250 18.26 4565
box Data file box made of chipboard w/ closed ends 6 72.57 435.42
box ENVELOPE Documentary for legal size docs 1 538.80 538.8
pc ERASER plastic/rubber for pencil draft/writing 6 6.23 37.38
pack Folder tag board for legal size documents 8 208.38 1667.04
pc Marker permanent bullet type BLACK 12 10.04 120.48
pc Marker permanent bullet tpe BLUE 12 10.04 120.48
pc Marker permanent bullet type RED 12 10.04 120.48
pad Note Pad stick on 500x76mm (2"x3"')min 12 32.45 389.4
pad Note Pad stick on 76mmx76mm(3"'x3'')min 12 44.32 531.84
pad Note Pad stick on 76mmx100mm(3''x4'')min 12 59.49 713.88
box Paper clip vinyl/plastic coat length 32mm min 6 6.91 41.46
box Paper clip vinyl/plastic coat length 48mm min 6 14.04 84.24
ream Paper Multi purpose (COPY) A4 70gsm 80 119.09 9527.2
ream Paper Multi purpose (COPY) Legal 70gsm 54 123.08 6646.32
Total >>>>>> 43596.88

Purpose:
CY 2018 SUPPLIES
Requested by: Approved by:

Signature:
Printed Name: MARLENE L. KAHANO RESTITUTO B. MACUTO
Designation SWO V/ARDA for Administration Regional Director
CERTIFYING AUTHORITIES
as to conformity to APP to fund source and conformity to WFP
CLARITO T. LOGRONIO BRIGIDA D. ESPEJO

OIC-DC, Administrative Division Chief, Financial Management Division
Revised 1994
APPLICATION FOR LEAVE
1. Office/Agency 2. Name (Last) (First) (Middle)
DSWD FO 08, Tacloban City BUGAL, AGNES ERGINA
3. Date of Filing 4. Position 5. Salary/Mo.
August 3, 2018 Social Welfare Officer III
6. a) Type of Leave 6. b) Where Leave will be spent
Vacation 1. In case of Vacation leave

To seek employment within the Philippines
/ Others (specify) abroad (specify)
Compensatory day-off 2. In case of Sick Leave

Sick In Hospital (specify)
Maternity
Out-patient (specify)
Others (specify)
d) Commutation
c) Number of working days applied for: Requested Not Requested
2 days
Inclusive Dates:
AGNES E. BUGAL
August 13-14, 2018 (Signature of Applicant)
Details of Action on Application
a) CERTIFICATE OF LEAVE CREDITS b) Recommendation

as of ( ) Approval
( ) Disapproval due to
Vacation Sick Total
Days Days Days

RESTITUTO B. MACUTO
NORABEL C. LAHIP Regional Director/RJJWC Chairperson
Administrative Officer V
c) Approved for: d) Disapproved due to:
Days VL/SL with pay
Days VL/SL without pay
Others (specify)
By Authority of the Secretary

of Social Welfare and Development
ATTY. TRICIA CLARE A. OCO

Executive Director
(Authorized Official)
STATEMENT OF ACCOUNT
Date Payee Particular/s Amount

Nov. 22, 2016 Ladera Artspot and Advertising 2 pcs. Tarpaulin 1,100.00
Nov. 22, 2016 Children's Place Specialty Store 3 doz. Balloons 450.00
Nov. 25, 2016 Jollibee, Zamora Tacloban snacks 2,800.00
Nov. 25, 2016 Stephanie Smoke Haus meals 2,000.00
xxxxxxxx nothing follows xxxxxxxxxxxxxxxxxxxxx
6,350.00
Prepared by:
AGNES E. BUGAL
Social Welfare Officeer III
Nov. 25, 2009 Tempura Haus, Japanese Rest. meal and snack Php 220.00
Nov. 25, 2009 Tempura Haus, Japanese Rest. meal and snack 2,500.00
Nov. 25, 2009 Access Office Systems xerox 20.00
Nov. 25, 2009 Benjamin Cuedas Fare 40.00
Nov. 25, 2009 Nestor Dacatimbang Fare 20.00
Nov. 25, 2009 M. Lorenzo Fare 20.00
Nov. 25, 2009 Enrique Gravoso Fare 50.00
Nov. 25, 2009 Mario Code Fare 12.00
Nov. 25, 2009 Joselito Neri Fare 26.00
Nov. 25, 2009 Zosimo Barado Fare 24.00
Total >>>>>>> Php 2,932.00
Prepared by:
MARLENE L. KAHANO
SWO IV-CBSU Head
March 6, 2009 Alpha Bakeshop bread Php 30.00

March 10, 2009 Dunkin' Donuts doughnut 27.00
March 13, 2009 Kitchenitos Foodhouse roast chicken, etc. 75.00
March 15, 2009 Wilmars Minimart mixed nuts, etc. 207.50
March 14, 2009 McDonald's Tacloban hamburger, etc. 225.00
March 21, 2009 Kitchenitos Foodhouse pork sinigang w/ rice, etc. 166.00
March 21, 2009 McDonald's Tacloban large fry, etc. 221.00
March 21, 2009 Leyte Dokiks Corp. porkcharap, etc. 167.00
March 23, 2009 Greenwich lasagna, etc. 166.00
March 23, 2009 Tacloban Quality Bread Center cake 750.00
March 23, 2009 Gaisano Capital coffee, etc. 64.00
March 24, 2009 Elena Homebaked pina roll 30.00
March 25, 2009 Jollibee Foods Corp. toppings, etc. 174.00
March 24, 2009 LR Mini Grocery ice cream loaded 69.00
March 25, 2009 Goldilocks Bakeshop mamon, etc. 63.00
March 26, 2009 Sarc Foods Corp spaghetti, etc. 162.00
March 25, 2009 Elena Homebaked rich brownies 104.00
March 25, 2009 Elena Homebaked raisin loaf,e tc. 123.00
March 26, 2009 Sarc Foods Corp ice tea, etc. 312.00
March 26, 2009 Sarc Foods Corp spaghetti, etc. 174.00
TOTAl >>>>>>> Php 3,547.50
Prepared by:
MARLENE L. KAHANO
SWO IV/OIC-DC Operations Division
April 27, 2009 Alex Maceda fare(to carry letter to Baybay, Leyte Php 30.00
April 27, 2009 M. Bolega fare (to carry letter to MacArhur, Leyt 20
April 29, 2009 Genaro Macabare fare (from Ritz Tower to Paperworld 12
April 29, 2009 Leyte Paperworld Main bookpapers, etc. 1,686.00
April 29, 2009 Benjamin Puno Fare (from FO to Paperworld) 12
April 28, 2009 Panato Bread Bakery sliced bread Php 32.00
April 28, 2009 leyte Paperworld Main bookpapers, etc. 1,170.00
April 29, 2009 Gaisano Capital coke 19.80
April 29, 2009 KFC, Tacloban City chicken, etc. 134.00
April 29, 2009 Leyte Paperworld Main expanding envelope 600.00
April 29, 2009 Hanz Graphics & Digital Imaging.. energizer battery 170.00
April 29, 2009 Leyte Paperworld Main manila paper, etc. 207.00
April 29, 2009 Leyte Paperworld Main masking tape 28.00
April 29, 2009 Tacloban Celebrity Plaza meals 185.00
April 29, 2009 Terry's Delicacies delicias, etc. 190.00
April 29, 2009 Terry's Delicacies chocolate moron 80.00
April 28, 2009 Mario de la Cruz Fare (from FO to Paperworld) 24.00
April 29, 2009 Godofredo Arcena fare (for 3 pax fr. FO to Ritz) 20.00
April 29, 2009 Renato Penida fare (from FO to Paperworld vice ver 24
April 29, 2009 Alfonso Cinco fare (from Ritz Tower to FO) 14
April 29, 2009 Arturo Villamor fare (from FO to Ritz Tower) 14
April 29, 2009 Willy Villamor fare(from downtown to FO) 18
April 29, 2009 Alfredo Buenas fare(from Rtiz to Hanz) 14
April 29, 2009 Eddie Galangue fare(from Rtiz to downtown for 2 pa 24
April 29, 2009 Pepito de Veyra fare (from Ritz to FO) 12
April 29, 2009 Leyte Paperworld Main ballpen, etc. 240
April 29, 2009 Renato Gozon fare (from Ritz to Leyte Paperworld) 12
Total >>>>>>> Php 5,003.80
Prepared by:
JOCELYN V. PEŇARANDA
SWO III
Certified True and Correct:
MARLENE L. KAHANO
OIC-Chief, Operations Division
ATTY. SIONNE AUJERO-GASPAY
Php 8,800.00
DSWD Field Office VIII DSWD Field Office VIII
Magsaysay Boulevard, Tacloban City Magsaysay Boulevard, Tacloban City
PASS SLIP PASS SLIP

Date Date
Employee Employee
Time Out Time Out

Official Personal Official Personal
Time In Time In
Distination: Distination:
Purpose: Purpose:
Approved by Approved by
Immediate Supervisor Immediate Supervisor
To be filed up by official business/transaction only To be filed up by official business/transaction only
CERTIFICATE OF APPEARANCE CERTIFICATE OF APPEARANCE

Trasaction Time Signature over printed name of Trasaction Time Signature over printed name of
Date Office person transacted with Position Date Office person transacted with Position
Start End Start End
Summary of Disbursement
N
Date of Receipt Supplier Particulars Amount e
t
11/17/17 Tacloban Mabuhay Glass Supply 4 pcs glass plaques 4,800.00
900.00
11/17/17 Children's Place Specialty Store 6 doz. Balloons with stick
11/20/17 Ladera Artspot & Advertising 8x6 ft tarpauline & 4x5 ft. tarpaulin 1,360.00
11/22/17 Leyte Paperworld 5 pcs Illustration board & 5 set Oil 650.00
Pastel
11/22/17 Leyte Paperworld 5 Illustration board 125.00
xxxxxxx nothing follows xxxxxxxx
GRAND TOTAL 7,835.00###
Prepared by:
AGNES E. BUGAL
APPROVED BUDGET FOR THE CONTRACT
Department of Social Welfare & Development Field Office VIII
Office of the Regional Director
(UNIT/PROGRAM)
Project:
Purchase Request No. :
VAT Unit
Item No. Description Quantity Unit Unit Price Total Cost
Other Taxes Cost
1 Mineral Water 240 jug 30.00 30.00 7,200.00
xxx
GRAND TOTAL 7,200.00

Date: __Jan. 7, 2019____, DSWD Field Office No. VIII
Funding Reference: Regular funds
Submitted by: Validated by: Conformed by: Conformed by:
MARLENE L. KAHANO MA. THERESA LEONORA B. COSTELO CLARITO T. LOGRONIO BRIGIDA D. ESPEJO
SWO V/ARDA Head, TWG for ABC Supervising Administrative Officer DC-FMD
FUND UTILIZATION REPORT
as of July 26, 2017
Beginning Balance …………………………………………… 1,637,700.00
Less: Report of Disbursements

Net
Date Payee Particulars Type of Expenses ADA/Check # Tax Gross
Amount
June 28, 2017 EDS labor and materials for the repair 1001308 3,731.25 248.75 3,980.00
repair
June 28, 2017 Joanna A. Berino TEV-May 2-June 9, 2017 Travelling Expenses 1001307 4,076.50 - 4,076.50
July 11, 2017 Heather Plus purchase of steel cabinets, etc equiment 1001311 22,070.72 1,249.28 23,320.00
July 17, 2017 PC Tools Computer Services swivel chair, etc. Office Supplies 1001313 7,418.48 419.92 7,838.40
July 14, 2017 Atty. Eleanor Calumpiano TE-May 23-27, 2017 Travelling Expenses 1001312 1,330.00 - 1,330.00
TOTAL
Total Disbursement this month…………………….. 40,544.90

Disbursement (previous period as of June 28, 2017)………. 32,911.60
Total Disbursement (as to date)…………………….. 73,456.50
Percentage of Utilization…………………………… 4.49
Cash Balance as of July 26, 2017 ………………….. 1,564,243.50
Prepared by: Certified by: Approved by:
JOANNA A. BERINO JULIETA S. REDONA RESTITUTO B. MACUTO

Administrative Assistant III AO V/OIC Head Actg. Regional Director
FUND UTULIZATION REPORT
as of _______________________ 2017
Date Payee Particulars Type of Expenses ADA/Check # Gross Tax

April 17, 2017 Joanna A. Berino TEV (Jan. 3-March 24, 2017) Travelling Expenses 1001301 4,661.00 -
LIBCAP delivery charges(Jan. 1-31, 2017) Postal/Courier 1001302 229.60
April 21, 2017 Services 14.35
delivery charges (2/8,10 & 15, Postal/Courier

April 21, 2017 LIBCAP 2017) Services 1001302 201.60 12.60
delivery charges (3/10,27,29, Postal/Courier

May 25, 2017 LIBCAP delivery charges (April 4,6,11,12, Postal/Courier 1001303 554.40 34.65
18,26, 2017) Services
May 25, 2017 Agnes. E. Bugal TEV (Jan.-April 2017) Travelling Expenses 1001304 16,679.00 -
Postal/Courier 1001305 187.49 14.11
June 16, 2017 LIBCAP delivery charges Services
15 pcs. Prepaid card for internet internet services 5,240.00
use
June 16, 2017 Leyte Paperworld 1001306 533.84
purchase of prepaid card for communication 4,076.50
communication use expenses
June 28, 2017 EDS labor and materials for the repair 1001308 3,980.00 248.75
repair
June 28, 2017 Joanna A. Berino TEV-May 2-June 9, 2017 Travelling Expenses 1001307 4,076.50 -
July 11, 2017 Heather Plus purchase of steel cabinets, etc equiment 1001311 23,320.00 1,249.28
July 17, 2017 PC Tools Computer Services swivel chair, etc. Office Supplies 1001313 7,838.40 419.92
July 4, 2017 Atty. Eleanor Calumpiano TE-May 23-27, 2017 Travelling Expenses 1001312 1,330.00 -
GRAND TOTAL 72,793.89 521.84
I HEREBY CERTIFY that the Report of Disbursement in one (1) page, in full is true and correct statement of all disbursements made by me and that this is
in liquidation of Fund Transfer granted last March 29, 2017 in the amount of Php 1,637,700.00 .
Prepared by:
JOANNA A. BERINO
Certified Correct by:
JULIETA S. REDOŇA
OIC,Regional Accountant, AO IV
Approved by:
RESTITUTO B. MACUTO
Regional Director/RJJWC Chair
Verified:
VICTORIA V. LAUZON
State Auditor IV
FUND UTULIZATION REPORT

as of June 1, 2017
ADA/Check
Date Payee Particulars Type of Expenses Gross Tax
#
April 17, 2017 Joanna A. Berino TEV (Jan. 3-March 24, 2017) Travelling Expenses 1001301 4,661.00 -
LIBCAP delivery charges(Jan. 1-31, 2017) Postal/Courier 1001302 229.60
April 21, 2017 Services 14.35
delivery charges (2/8,10 & 15, Postal/Courier

delivery charges (3/10,27,29, Postal/Courier

LIBCAP delivery charges (April 4,6,11,12, Postal/Courier 1001303 554.40

May 25, 2017 18,26, 2017) Services 34.65
delivery charges (April 4,6,11,12,
18,26, 2017)
May 25, 2017 Agnes. E. Bugal TEV (Jan.-April 2017) Travelling Expenses 1001304 16,679.00 -
GRAND TOTAL 22,745.00 87.81
Prepared by:
JOANNA A. BERINO
Certified Correct by:
JULIETA S. REDOŇA
Administrative Officer IV/OIC Head, Actg. Unit
Approved by:
RESTITUTO B. MACUTO
Regional Director
Net Amount
4,661.00
215.25
189.00
393.19
519.75
16,679.00
173.38
9,431.16
3,731.25 EDS licensed anti-virus sca Office Supplies 1,355.00

Hanz Graphics & Digital signage Office Supplies 1,000.00
4,076.50 Imaging
22,070.72 PC Tools Computer swivel chair, etc. Office Supplies 7,838.40
Services
7,418.48
1,330.00
New Five Star sign pen, etc Office Supplies 6,898.00
Sophias Way Food 1 meal and 2 snacks training expenses 24,000.00
Center for 2 meetings
Seafoods and Ribs 1 meal and 2 snacks training expenses 24,000.00
Restaurant Warehouse for 2 meetings
Granda Manor 3 meals and 2 snacks training expenses 40,000.00
Leyte Paperworld notebook, etc. training expenses 22,705.00
Ocean View Hotel board and lodging training expenses 124,000.00
???? honorarium consultancy 20,000.00

expesnes
70,888.68 71,410.52
nts made by me and that this is

Net Amount
4,661.00
215.25
189.00
393.19
519.75
16,679.00
22,657.19
Checklist of Documents (Pre)
for Regular/Special Meeting
Items Date Prepared Remarks

Project Proposal (CY 2017) March 31, 2017
Requisitioned and Issued Slip April 5, 2017
Purchase Request (CY 2017) April 5, 2017
Approved ABC April 19, 2017
Menu April 5, 2017
Attendance Sheets (1st Qtr. Meeting) July 7, 2017
Notice of Meeting (1st Qtr. Meeting) March 3, 2017
Faciltiated Signature of P.O
Follow-up Documentary
Requirements of winning Service July 3-14, 2017
Provider
Prepared Certificate of Appearance
Prepared Inspection and Acceptance
Report
Prepared by:
JOANNA A. BERINO
Noted by:
AGNES E. BUGAL
SWO III
Checklist of Documents (During)
Writeshop on the development of CLJIP to LGUs
July 18-21, 2017

Facilitated Registration of Participants July 18-21, 2017
Photo Documentation July 18-21, 2017
Assisted on the use of projector July 18-21, 2017
Assisted during the workhop July 18-21, 2017
Prepared by:
JOANNA A. BERINO
Noted by:
AGNES E. BUGAL
SWO III
Checklist of Documents (After)

for Regular/Special Meeting

Prepared Disbursement Voucher July 24, 2017
Prepared Certificate of Services Rendered July 28, 2017
Prepared Justification (if applicable) July 31, 2017
Attached attendance sheets for payment July 24, 2017
Prepared Inspection and Acceptance Report July 24, 2017
Attached Billing Statement July 24, 2017
Requested for PhilGeps Award July 26, 2017
Prepared by:
JOANNA A. BERINO
Noted by:
AGNES E. BUGAL
SWO III
Checklist of Documents (Pre)

Writeshop on the development of CLJIP to LGUs
July 18-21, 2017

Project Proposal (CY 2017) March 31, 2017
Prepared Requisitioned and Issued Slip April 5, 2017
Prepared Purchase Request April 5, 2017
Prepared ABC April 19, 2017
Prepared Menu April 5, 2017
Prepared Attendance Sheets July 7, 2017
Facilitated distribution of letters of Invitation March 3, 2017
Faciltiated Signature of P.O July 17, 2017
Followed-up Documentary Requirements of
winning Service Provider July 3-14, 2017
Prepared Certificate of Appearance July 12, 2017
Prepared Certificate of Participation July 12, 2017
Encoded and printed Program of Activities July 12, 2017
Prepared Travel Order of Secrertariat July 14, 2017
Prepared kit July 17, 2017 P.O is still for approval,
borrowed items from
other program as of 7/17
Request for Inspector July 13, 2017
Prepared by:
JOANNA A. BERINO
Noted by:
AGNES E. BUGAL
SWO III
(053) 321-2040; email add: agnes_bugal@yahoo.com; joannaberino@yahoo.com
Date Place/s Purpose of Travel Signature

CS FORM NO. 48 CS FORM NO. 48
DAILY TIME RECORD DAILY TIME RECORD

NAME: AGNES E. BUGAL NAME: AGNES E. BUGAL
For the month of July 1-31, 2018 For the month of July 1-31, 2018
Official Hours for Arrival and Departure Official Hours for Arrival and Departure
Regular Days: Regular Days:
Saturdays: Saturdays:
AM PM UNDERTIME AM PM UNDERTIME
DATE ARRIVAL DEPARTURE ARRIVAL DEPARTURE DATE ARRIVAL DEPARTURE ARRIVAL DEPARTURE
IN OUT IN OUT HOURS MINUTE IN OUT IN OUT HOURS MINUTE

1 Sunday 1 Sunday
2 7:42 12:10 12:40 5:15 2 7:42 12:10 12:40 5:15
3 3
4 O.B @USAID Training center, 4 O.B @USAID Training center,
Tacloban City Tacloban City
5 5
6 7:35 12:10 12:40 5:05 6 7:35 12:10 12:40 5:05
7 Sturday 7 Sturday
8 Sunday 8 Sunday
9 7:41 12:10 12:39 5:08 9 7:41 12:10 12:39 5:08
10 7:40 12:15 12:48 5:10 10 7:40 12:15 12:48 5:10
11 7:38 12:15 12:49 5:11 11 7:38 12:15 12:49 5:11
12 7:41 12:11 12:51 5:04 12 7:41 12:11 12:51 5:04
13 7:39 12:11 12:43 5:15 13 7:39 12:11 12:43 5:15
14 Saturday 14 Saturday
15 15
16 16
17 O.B. @ Tolosa, Leyte 17 O.B. @ Tolosa, Leyte
18 18
19 19
20 O.B @ CSWDO Tacloban City 20 O.B @ CSWDO Tacloban City
22 Sunday 22 Sunday
O.B @ Hotel Consuelo, Tac. O.B @ Hotel Consuelo, Tac.

23 7:45 City (3rd Regular Meeting) 23 7:45 City (3rd Regular Meeting)
24 7:40 12:10 12:45 5:10 24 7:40 12:10 12:45 5:10

25 O.B. @ Ormoc City 25 O.B. @ Ormoc City
26 O.B @ Baybay City 26 O.B @ Baybay City
27 O.B @ Maasin City 27 O.B @ Maasin City
29 Sunday 29 Sunday
30 30
31 Compensatory Day-Off 31 Compensatory Day-Off
TOTAL UT TOTAL UT
I Certify on my honor that the above is a true and I Certify on my honor that the above is a true and
correct report of the Hours of work performed, record of correct report of the Hours of work performed, record of
which was made Daily at the time of Arrival and Departure which was made Daily at the time of Arrival and Departure
from office. from office.
(Signature) (Signature)
Verified as to prescribed office Hours. Verified as to prescribed office Hours.
RESTITUTO B. MACUTO RESTITUTO B. MACUTO

Regional Director Regional Director
PRE-INSPECTION
Supplier Date February 22, 2017

Requisitioning Office/Dept. DSWD-RJJWC
unit Brother Printer (MFC-9140 CDN) 1

xxxxxxxxxxxx nothing follows xxxxxxxxxxxxxxxx
PRE-INSPECTION Remarks:
Date Inspected:
Inspection Officer
DISTRIBUTION SHEET
Prepaid Cards for the 3rd and 4th Qtr. 2017 (Comm. and Internet use)
# of Prepaid Cards
Prepaid cards Name & Position Signature
300 100
Agnes E. Bugal, SWO III 22 22
Globe
14 1 15
Joanna A. Berino, AdAsst. III
Smart 3 3
Prepared by:
JOANNA A. BERINO
Noted by:
AGNES E. BUGAL
SWO III
STATEMENT OF OVERTIME SERVICES RENDERED
Name : ORVILLE C. BERINO

For the month of : November 2013
Official Hours for Arrival and Derparture
AM PM Regular Days Saturday/Sunday

Date Day Arrival Departure Arrival Departure
Hours Minute Hours Minute
IN OUT IN OUT
1 Holiday
2 Saturday
3 Sunday
4 8:15 12:00 12:30 5:35
5 7:58 12:00 12:40 5:20
6 8:30 12:00 12:35 6:15
7 7:15 12:00 12:41 8:30
8 typhoon "YOLANDA"
9 Saturday
10 S / 7:30 6:30
O.B @ seaport
11 7:25 6:15
12 calamity leave
13 6:50 O.B @ Guiuan, E. Samar 9:00
14 6:30 6:25
15 10:54 O.B @ seaport 7:15
16 S / 9:34 8:10
17 Sunday
18 special exemption/calamity leave
19 7:54 6:40
20 8:33 8:50
21 9:16 O.B @ seaport 4:13
22 9:34 7:49
23 S / 5:59 8:15
24 Sunday
25 7:58 4:43
O.B @ seaport
26 8:30 6:30
27 8:42 5:16
28 8:27 8:30
O.B @ airport
29 7:15 10:00
30 6:45 9:58
31 xxxxxxx
TOTAL OVERTIME
Regular Days Sat./Sun./Holidays

Rate/Hour Hrs. x 150%
Rate/Min. mins. x 150%
Salary/Mo.
Approved for PAYMENT ON THE AMOUNT OF _____________________ the above expenses have
been incurred under my authority in the interest of public service and the charge being just and reasonable
as verify believable.
NESTOR B. RAMOS
Regional Director
Name : NESTOR B. RAMOS

For the month of : December 2013

IN OUT IN OUT
1 5:30 10:18
2 5:15 9:30
3 5:20 10:11
4 5:40 8:50
O.B @ Airport HUB
5 6:15 10:30
6 5:25 12:35
7 6:40 9:40
8 5:48 7:30
9
on leave
10
11 6:00 8:20
12 6:15 7:55
13 6:20 8:20
14 6:10 8:50
15 6:17 O.B @ Airport HUB 7:50
16 6:20 8:10
17 6:15 8:20
18 6:00 9:08
19 5:35 7:00
20 compensatory day of
21 Saturday
22 Sunday
23 compensatory day of
24
Holiday
25
26
compensatory day of
27
28 Saturday
29 6:45 8:20
30 7:00 O.B @ Isabel, Leyte HUB 7:30
31 7:30 6:00
TOTAL OVERTIME

Salary/Mo.
NESTOR B. RAMOS
Regional Director
DISTRIBUTION SHEET
Quantity unit Particular/s Name of Staf Signature
7 pcs. Globe Agnes E. Bugal, SWO III
2 pcs. Globe Joanna A. Berino, AdAsst. III
Prepaid by:
JOANNA A. BERINO
AdAsst. III
Noted by:
AGNES E. BUGAL
SWO III
DISTRIBUTION SHEET
for internet use for period January to June 2017
Quantity unit Particular/s Name of Staf Signature
9 pcs. Globe Agnes E. Bugal, SWO III
6 pcs. Globe Joanna A. Berino, AdAsst. III
15
Prepaid by:
JOANNA A. BERINO
AdAsst. III
Noted by:
AGNES E. BUGAL
SWO III
UNCIL

For the month of : : February 2014

IN OUT IN OUT
1 Sat. 7:05 12:15 1:00 6:55
2 Sun. 7:10 12:00 12:20 7:30
3 Mon.
4 Tues.
5 Wed. calamity leave
6 Thur.
7 Fri.
8 Sat.
9 Sun. 2:30 7:00
10 Mon. 8:25 12:30 1:00 7:05
11 Tues. 8:20 12:00 1:00 7:15
12 Wed. 8:50 12:17 12:50 7:55
13 Thur. 8:25 12:00 12:30 6:50
14 Fri. 8:30 12:17 1:00 8:50
15 Sat. 7:35 12:37 1:00 7:15
16 Sun.
17 Mon. O.B @ FO8
18 Tues. O.B @ ISABEL / PALOMPON
19 Wed. 8:55 12:00 12:37 7:00
20 Thur. 7:50 12:40 1:00 8:20
21 Fri. 7:00 12:00 1:00 7:40
22 Sat. 9:25 12:00 12:30 7:45
23 Sun.
24 Mon. 7:57 12:15 12:55 8:00
25 Tues. 8:55 12:00 1:00 8:30
26 Wed. 8:25 12:10 12:35 8:40
27 Thur. 8:35 12:00 12:50 8:00
28 Fri. 8:30 12:00 12:50 7:15
29 xxxxxxxxxxxx
30
31
TOTAL OVERTIME

Salary/Mo.
Prepared by: Recommending Approval: Approved by:
ORVILLE C. BERINO MARLENE L. KAHANO NESTOR B. RAMOS

AO II/OIC Head AU SWO IV/OIC DC, GASSD OIC Regional Director

For the month of : : March 2014

IN OUT IN OUT
1 Sat. 7:30 12:15 1:00 7:15
2 Sun. 10:06 12:25 12:50 7:30
3 Mon. 8:42 12:05 1:00 7:50
4 Tues. 8:30 12:30 12:59 8:02
5 Wed. 7:50 12:12 1:00 7:40
6 Thur. 8:02 12:02 12:35 7:52
7 Fri. 8:20 12:15 1:00 7:45
8 Sat. 10:05 12:00 12:45 8:15
9 Sun.
10 Mon. 7:45 12:10 12:55 7:30
11 Tues. 8:40 12:15 12:58 7:00
12 Wed. 8:30 12:00 1:00 7:50
13 Thur. 8:15 12:25 1:00 8:00
14 Fri. 8:45 12:15 1:00 7:55
15 Sat. 8:15 12:30 12:50 7:30
16 Sun.
17 Mon. 7:51 12:00 1:00 6:00
18 Tues. 8:30 12:00 12:50 7:34
19 Wed. 8:39 12:10 12:50 7:30
20 Thur. 8:37 12:20 1:00 7:30
21 Fri. 8:38 12:00 1:00 7:48
22 Sat.
23 Sun.
24 Mon. 10:15 12:30 1:00 7:30
25 Tues. calamity leave
26 Wed.
27 Thur.
28 Fri.
29 Sat.
30 Sun.
31 Mon. 8:04 12:00 1:00 8:23
TOTAL OVERTIME

Salary/Mo.
Prepared by: Recommending Approval: Approved by:
ORVILLE C. BERINO MARLENE L. KAHANO NESTOR B. RAMOS

AO II/OIC Head AU SWO IV/OIC DC, GASSD OIC Regional Director
DSWD Field Office VIII DSWD Field Office VIII
Tacloban City Tacloban City
PASS SLIP PASS SLIP
Date: Date:
Employee : Employee :
Time In Time In
Official Personal Time Out Official Personal Time Out
Destination: Destination:
Purpose Purpose
Approved by: Approved by:
Immediate Supervisor Immediate Supervisor
To be filled up for official/transaction only To be filled up for official/transaction only
CERTIFICATE OF APPEARANCE CERTIFICATE OF APPEARANCE
Transaction Time Transaction Time

Signature Over Printed Name Position Signature Over Printed Name Position
Date Office of Person Transacted With Date Office of Person Transacted With
Start End Start End
REGULAR MEETING
August 16, 2016
Granda Manor, Tacloban City
FOLLOW-UP ON CONFIRMATON OF ATTENDANCE
Dates
Name of Member
July 29, 2016 August 3, 2016 August 9, 2016 August 12, 2016
1) Atty. Wilfredo Estorninos
Vice Chairperson, DOJ
2) Atty. Vevelyn Monsanto
Member, PAO
3) Atty. Eleanor Calumpiano
Member, DepEd
4) Atty. Marierose Alvero
Member, CHR
5) Ms. Jenna Negros
DILG
6) Mr. Enrico Baloro
Plan International
7) Ms. Julie Muriel
TESDA
8) SJO2 Eva Naputo
BJMP
9) SP04 Marissa Monge
WCPD, PNP
10) Ms. Chona Bahin
CSWDO
11) Dr. Minerva Molon
DOH
Remarks
No. :
OBLIGATION REQUEST AND STATUS Date:
DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT Fund:
Payee
JOANNA A. BERINO
Office

UACS
Responsibility Center Particulars MFO/PAP Amount
Code/Expenditure
Obligation request to reimbursemet of

traveling expenses incurred during official travel 2,268.00
as per supporting papers are hereto attached in
the amount of ………………
2,268.00
Certified: Charges to budget necessary, lawful and under my direct supervision; Certified: Budget available and utilized for the purpose/ adjustment
A. necessary as indicated above.
and supporting documents valid, proper and legal.
Signature Signature
Printed
Printed Name MARLENE L. KAHANO Name BRIGIDA D. ESPEJO
SWO IV/OIC ARDA AO V/Budget Officer

Position Position
Head, Requesting Office/Authorized Representative Head, Budget Unit/Authorized Representative
Date Date
C. STATUS OF OBLIGATION
Reference Amount
Date Particulars BURS/JEV/RCI, etc. Obligation Payment Not Yet Due Due and Demendable
Totals
Checklist of Needed Documents:
Activity: Orientation on R.A 9344 as amended and No to Lowering of MACR

on September 2, 2016 at Baybay City, Leyte
Document/s Yes No Remarks

1) Certificate of Appearance
2) Certificate of Appreciation/ Participation LGUs counterpart

3) Attendance Sheet /
4) Evaluation Form /
Date Place/s Visited Purpose Signature & Date

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INSPECTION AND ACCEPTANCE REPORT

Supplier: KS BEE CATERING SERVICES IAR No.:____________

Date Inspected: __________________________ Date Received:

Inspected, verified and found in order as to Complete

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Prepared by: Recommending Approval:

DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT Fund Cluster :

Mode of MDS Check Commercial Check ADA Others (Please specify)

Amount Due 24,000.00

C. Certified: D. Approved for Payment

Subject to Authority to Debit Account (when applicable)

To liquidation of FUND TRANSFER for the implementation of projects

Total Amount Spent

PLACE/S DATE/S TRANSPORTATION

Ormoc City August 20, 2018 PUV/PUJ

1) Attend Team Building Activity

It is understood that a report shall be submitted upon completion of this travel

SUPPLEMENTAL PROJECT PROCUREMENT MANAGEMENT PLAN (SPPMP)

Name of Office/Bureau/Service/Unit: Office of the Asst. Regional Director for Operations

Contract ProcurementTime Schedule for each

GRAND TOTAL Php7,000.00

Prepared by: Noted by: Approved by:

JOANNA A. BERINO NESTOR B. RAMOS REMIA T. TAPISPISAN

Travel Order No. 16 , series of 2018 is hereby amended as to :

include as among ther participants to

1.) To Follow-up compliance of CLJIP

Instead of It should be:

May 15-17, 2018 May 16-18, 2018

PSWDO, Southern Leyte

Official(s) staff to be included:

AGNES E. BUGAL, SWO III

BUDGET UTILIZATION REQUEST AND STATUS Serial No. : ___________________

Payee LIBCAP SUPER EXPRESS CORP.

Address Tacloban City

Particulars MFO/PAP UACS Object Code/

To request budget utilization of Delivery RJJWC Trust

as per attached supporting papers

Signature ____________________________________ Signature : _______________________________

PLACE/S DATE/S TRANSPORTATION

Federal Phoenix Insurance Company, March 28, 2015 taxi

Disccussed with account officer of insurance company the additional requirements

Department of Social Welfare and Development

Entity Name: ORD Fund Cluster :

Division ORD Responsibility Center Code :

Requisition Stock Available ? Issue

Purpose/Remarks CY 2018 SUPPLIES

Requested by Approved by: Issued by: Received by:

REQUISITION AND ISSUE SLIP

Department of Social Welfare and Development

Entity Name: ORD Fund Cluster :

Division ORD Responsibility Center Code :

Requisition Stock Available ? Issue

pc Stam pad FELT bed dimension 60mmx100mm min 2

Purpose/Remarks CY 2018 SUPPLIES

Requested by Approved by: Issued by: Received by:

This is to certify that Mr./Ms. JEEKERIN OSONIO has appeared in

for the CAR and CICL Registry

(state the purpose and the area/place)

Please affix your signature on

Did not provide hotel /lodging

Provided the following:

This is to CERTIFY that

This is to CERTIFY that

Signature ______ Signature : _