DEPARTMENT OF LABOR AND EMPLOYMENT

Regional Office No. 6, Iloilo City

No .:
ITINERARY OF TRAVEL
Date :
Name : LIZA C. VILLALBA Position : GIP Monthly Salary :
Official Station : DOLE RO 6-Capiz Residence : Dumarao, Capiz
Purpose of Travel :

Date Places to be visited Time Means of Amount

2021 (Destination) Departure Arrival Transportation Fare Per Total
diems

Official station to Brgy. Alipaciawan, sitio

2/8/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Official station to Brgy. Alipaciawan, sitio

3/8/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Official station to Brgy. Alipaciawan, sitio

4/8/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Official station to Brgy. Alipaciawan,Sitio

5/8/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Railway, Dumarao Capiz

Brgy. Alipaciawan to PESO LGU Dumarao

6/8/2021 7:55am 5:00 PM Habal-habal 60.00 60.00
Capiz

Official station to Brgy. Alipaciawan, sitio

9/8/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Official station to Brgy. Alipaciawan, sitio

10/8/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Official station to Brgy. Alipaciawan, sitio

11/8/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Official station to Brgy. Alipaciawan, sitio

12/8/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Brgy. Alipaciawan to PESO LGU Dumarao

08/13/2021 7:55am 5:00 PM Habal-habal 60.00 60.00
Capiz
Official station to Brgy. Alipaciawan, sitio
08/16/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Official station to Brgy. Alipaciawan, sitio

08/17/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz
Brgy. Alipaciawan to PESO LGU Dumarao
08/18/2021 7:55am 5:00 PM Habal-habal 60.00 60.00
Capiz

Official station to Brgy. Alipaciawan, sitio

08/19/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz
Official station to Brgy. Alipaciawan, sitio
08/20/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Official station to Brgy. Alipaciawan, sitio

08/23/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz
Official station to Brgy. Alipaciawan, sitio
08/24/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Official station to Brgy. Alipaciawan, sitio

08/25/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz
Official station to Brgy. Alipaciawan, sitio
08/26/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz

Official station to Brgy. Alipaciawan, sitio

08/27/2021 7:55am 5:00 PM Habal-habal 40.00 40.00
Proper, Dumarao Capiz
Brgy. Alipaciawan to PESO LGU Dumarao
08/31/2021 7:55am 5:00 PM Habal-habal 60.00 60.00
Capiz

Total 920.00
I hereby certify that (1) I have the knowledge regarding Prepared by:
the travel; (2) the travel is necessary; (3) the peridod covered is
reasonable; and (4) the expenses claimed are proper.

LIZA C. VILLALBA
 GIP
AMALIA N. JUDICPA Approved by:
OIC-Head, Capiz Field Office

ATTY. SIXTO T. RODRIGUES, JR

Regional Director
 DEPARTMENT OF LABOR AND EMPLOYMENT Fund Cluster :
REGIONAL OFFICE VI
Date :
DISBURSEMENT VOUCHER DV No. :

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

Payment
_________________
TIN/Employee No.: ORS/BURS No.:
Payee LIZA C. VILLALBA

Address DOLE RO 6, ILOILO CITY

Responsibility
Particulars MFO/PAP Amount
Center

₱ 820.00
To payment of traveling expenses and
per diems while on official travel outside of
Official Station per IT No. _______________
in the amount of

Amount Due ₱ 820.00

A. Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision.

AMALIA N. JUDICPA
Officer-In-Charge
B. Accounting Entry:
Account Title UACS Code Debit Credit
Traveling Expenses - Local 5-02-01-010 820.00
Cash MDS Regular 1-01-04-040 820.00

C. Certified: D. Approved for Payment ₱ 820.00

Cash available
Subject to Authority to Debit Account (when applicable)
EIGHT HUNDRED TWENTY PESOS ONLY
Supp
proper

Signature Signature

Printed
MARY JANE B. ITALIA-JASARINO Printed Name ATTY. SIXTO T. RODRIGUES, JR
Name

Position Accountant III Position Regional Director

Date Date
E. Receipt of Payment JEV No.
Check/ Date : Bank Name & Account Number:
ADA No. :
Date : Printed Name: Date
Signature :
LIZA C. VILLALBA

Official Receipt No. & Date/Other Documents

 Annex F

OBLIGATION REQUEST AND STATUS No :

DEPARTMENT OF LABOR AND EMPLOYMENT RO6 Date :

Agency Fund :
Payee LIZA C. VILLALBA
Office DOLE RO 6
Address Iloilo City
Responsibility Particulars MFO/PAP UACS Code/ Amount
Center Expenditure

820.00
To payment of traveling expenses and
per diems while on official travel outside of
Official Station per IT No.
_______________ in the amount of

Total 820.00
A Certified : Charges to the appropriation/ allotment necessary, B Certified: Allotment available and obligated for the
lawful and under my direct supervision; and supporting purpose/adjustment necessary as indicated above
documents valid, proper and legal.

Signature : Signature :
Printed Name : AMALIA N. JUDICPA Printed Name : RHIA MAE M. MILLOROSO
Position : Officer-In-Charge Position : Admin. Officer V
Date : Date :

C STATUS OF OBLIGATION
Reference Amount
Date Particulars ORS/JEV/RCI/RADAI No. Obligation Payment Not Yet Due
Due and Demandable

Totals
 Republic of the Philippines
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
Iloilo City
CERTIFICATE OF TRAVEL COMPLETED
ATTY. SIXTO T. RODRIGUES, JR DOLE, Regional Office 6
Agency Head Station
Regional Director
Position Date
I CERTIFY THAT I have completed the travel authorized in 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 returned under O.R. No. ,
dated .
Extended as explained below. Additional itinerary was submitted.

Other deviations as explained below:

Explainations or justifications:

Evidences of travel:
Used ticket
P Certificate of Appearance
P Others:

Respectfully submitted by:

LIZA C. VILLALBA
GIP
On evidence and information of which I have knowledge, the travel was actually
undertaken.

ATTY. SIXTO T. RODRIGUES, JR

Regional Director
 ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated July 5, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Brgy. Alipaciawan to PESO LGU Dumarao Capiz 60.00

Total 60.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated July 6, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official station to Brgy. Alipaciawan, sitio Proper, Dumarao Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name ANA FE D. DORDAS AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated July 7, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official station to Brgy. Alipaciawan,Sitio Bulan-es, Dumarao Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name ANA FE D. DORDAS AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date
 ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated August 2, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated August 3, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official station to Brgy. Alipaciawan, sitio Proper, Dumarao Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

 I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated August 4, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
 Pursuant to COA Circular No. 2017-001 dated August 5, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official station to Brgy. Alipaciawan,Sitio Railway, Dumarao Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date
 ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated August 6, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Barangay Alipaciawan to PESO LGU Dumarao, Capiz 60.00

Total 60.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated August 9, 2021, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

 I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated August 10, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
 Pursuant to COA Circular No. 2017-001 dated August 11, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date
 ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated August 12, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated August 13, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Brgy. Alipaciawa to PESO LGU Dumarao, Capiz 60.00

Total 60.00
Purpose

Profiled Child Laborers

 I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated August 16, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
 Pursuant to COA Circular No. 2017-001 dated August 17, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date
 ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated August 18, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Brgy. Alipaciawan to PESO LGU Dumarao, Capiz 60.00

Total 60.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated August 19, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

 I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated August 20, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official station to Brgy. Alipaciawan,Sitio Proper, Dumarao Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
 Pursuant to COA Circular No. 2017-001 dated August 23, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official station to Brgy. Alipaciawan,Sitio Proper, Dumarao Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date
 ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated August 24, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated August 25, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

 I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6

CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS

Pursuant to COA Circular No. 2017-001 dated August 26, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date

ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
 Pursuant to COA Circular No. 2017-001 dated August 27, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Official Station to Brgy. Alipaciawan sitio Proper, Dumarao, Capiz 40.00

Total 40.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date
 ANNEX A
DEPARTMENT OF LABOR AND EMPLOYMENT
Regional Office No. 6
CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS
Pursuant to COA Circular No. 2017-001 dated August 31, 2021

Name of Employee LIZA C. VILLALBA Employee No.

Office DOLE RO 6
Division DOLE-CAPIZ
Particulars Amount

Brgy. Alipaciawan to PESO LGU Dumarao 60.00

Total 60.00
Purpose

Profiled Child Laborers

I hereby certify that the above expenses are incurred as they are necessary for the above cited purpose, that the
above goals were acquired from parties not issuing receipts. And that I am fully aware that wilful falsification of
statements is punishable by law.

Certified Correct: Noted by:

Signature
Printed name LIZA C. VILLALBA AMALIA N. JUDICPA
GIP Officer-In-Charge
Date Date