REQUEST FORM
(Request Use of Vehicle)
Date: ________________
Name of Requesting Personnel:
Travel Authority No:
Destination/Purpose:
Date and Duration of Travel:
Government Vehicle/Plate No. :
No. of Passengers:
Name of Passengers:
Requested by:
___________________________ Action Taken:
Approve
Disapprove due to _____________________________
SHERALYNE D. PEQUINA
Administrative Officer - V
REQUEST FORM
(Request Use of Vehicle)
Date: ________________
Name of Requesting Personnel:
Travel Authority No:
Destination/Purpose:
Date and Duration of Travel:
Government Vehicle/Plate No. :
No. of Passengers:
Name of Passengers:
Requested by:
__________________________ Action Taken:
Approve
Disapprove due to _____________________________
SHERALYNE D. PEQUINA
Administrative Officer - V
AUTHORITY TO TRAVEL
Control No.
REGION: CARAGA
BUREAU/DIVISION/SCHOOL: DIVISION OF DINAGAT ISLANDS
Date of Filing
NAME Karen L. Galanida, PhD, CESO VI
Position/Designation Schools Division Superintendent
Permanent Station Division of Dinagat Islands
Purpose of Travel
Activity Organized/
Sponsored By
Period Covered (Inclusive
Time of Travel)
Please Check Official Business Official Time
Venue/Destination
Expenses Covered
Fund Source (PAP
Code/…)
Recommending Approval: Approved:
LEONEVEE V. SILVOSA FRANCIS CESAR B. BRINGAS, CESO V
OIC - Assistant Schools Division Superintendent OIC - Regional Director
Date: _______________ Date: _______________
AUTHORITY TO TRAVEL
Control No.
REGION: CARAGA
BUREAU/DIVISION/SCHOOL: DIVISION OF DINAGAT ISLANDS
Date of Filing
NAME Leonevee V. Silvosa
Position/Designation Assistant Schools Division Superintendent
Permanent Station Division of Dinagat Islands
Purpose of Travel
Activity Organized/
Sponsored By
Period Covered (Inclusive
Time of Travel)
Please Check Official Business Official Time
Venue/Destination
Expenses Covered
Fund Source (PAP
Code/…)
Recommending Approval: Approved:
LEONEVEE V. SILVOSA KAREN L. GALANIDA, PhD, CESO VI
OIC - Assistant Schools Division Superintendent Schools Division Superintendent
Date: _______________ Date: _______________
AUTHORITY TO TRAVEL
Control No.
REGION: CARAGA
BUREAU/DIVISION/SCHOOL: DIVISION OF DINAGAT ISLANDS
Date of Filing
NAME Leonevee V. Silvosa
Position/Designation OIC - Assistant Schools Division Superintendent
Permanent Station Division of Dinagat Islands
Purpose of Travel
Activity Organized/
Sponsored By
Period Covered (Inclusive
Time of Travel)
Please Check Official Business Official Time
Venue/Destination
Expenses Covered
Fund Source (PAP
Code/…)
Recommending Approval: Approved:
KAREN L. GALANIDA, PhD, CESO VI FRANCIS CESAR B. BRINGAS, CESO V
Schools Division Superintendent OIC - Regional Director
Date: _______________ Date: _______________
AUTHORITY TO TRAVEL
Control No.
REGION: CARAGA
BUREAU/DIVISION/SCHOOL: DIVISION OF DINAGAT ISLANDS
Date of Filing September 6, 2019
NAME Lope C. Papeleras, PhD
Position/Designation Chief ES, CID
Permanent Station Division of Dinagat Islands
To attend the conduct of Workshop for the Preparation and Submission of
Purpose of Travel
Inventory of DepEd Personnel
Activity Organized/
DepEd Regional (RM No. 495, s. 2019 dated August 30, 2019)
Sponsored By
Period Covered (Inclusive
September 12-13, 2019
Time of Travel)
Please Check Official Business Official Time
Venue/Destination Butuan City
Expenses Covered Traveling expenses
Fund Source (PAP
Division Local Funds
Code/…)
Recommending Approval: Approved:
LEONEVEE V. SILVOSA KAREN L. GALANIDA, PhD, CESO VI
OIC - Assistant Schools Division Superintendent Schools Division Superintendent
Date: _______________ Date: _______________
AUTHORITY TO TRAVEL
Control No.
REGION: CARAGA
BUREAU/DIVISION/SCHOOL: DIVISION OF DINAGAT ISLANDS
Date of Filing September 6, 2019
NAME Mila O. Geraldino, PhD
Position/Designation Chief ES, SGOD
Permanent Station Division of Dinagat Islands
To attend the conduct of Workshop for the Preparation and Submission of
Purpose of Travel
Inventory of DepEd Personnel
Activity Organized/
DepEd Regional (RM No. 495, s. 2019 dated August 30, 2019)
Sponsored By
Period Covered (Inclusive
September 12-13, 2019
Time of Travel)
Please Check Official Business Official Time
Venue/Destination Butuan City
Expenses Covered Traveling expenses
Fund Source (PAP
Division Local Funds
Code/…)
Recommending Approval: Approved:
LEONEVEE V. SILVOSA KAREN L. GALANIDA, PhD, CESO VI
OIC - Assistant Schools Division Superintendent Schools Division Superintendent
Date: _______________ Date: _______________
AUTHORITY TO TRAVEL
Control No.
REGION: CARAGA
BUREAU/DIVISION/SCHOOL: DIVISION OF DINAGAT ISLANDS
Date of Filing
Name/s &
Position/Designation
Permanent Station Division of Dinagat Islands
Purpose of Travel
Activity Organized/
Sponsored By
Period Covered (Inclusive
From To
Time of Travel)
Please Check Official Business Official Time
Venue/Destination
Expenses Covered
Fund Source (PAP
Code/…)
Recommending Approval: Approved:
LEONEVEE V. SILVOSA KAREN L. GALANIDA, PhD, CESO VI
OIC - Assistant Schools Division Superintendent Schools Division Superintendent
Date: _______________ Date: _______________
AUTHORITY TO TRAVEL
Control No.
REGION: CARAGA
BUREAU/DIVISION/SCHOOL: DIVISION OF DINAGAT ISLANDS
Date of Filing October 16, 2019
NAME Welfer L. Erno, Jr.
Position/Designation ADAS III
Permanent Station Division of Dinagat Islands
Purpose of Travel To deliver LDDAP-ADA and ACIC
Activity Organized/
Sponsored By
Period Covered (Inclusive
From October 17, 2019 To October 17, 2019
Time of Travel)
Please Check / Official Business Official Time
Venue/Destination DBP, Surigao City
Expenses Covered
Fund Source (PAP
Code/…)
Recommending Approval: Approved:
LEONEVEE V. SILVOSA KAREN L. GALANIDA, PhD, CESO VI
OIC - Assistant Schools Division Superintendent Schools Division Superintendent
Date: _______________ Date: _______________
