Fare ReimbursementREIMBURSEMENT FOR EXTRA FARE EXPENSES

SUMMARY:Name: Alvarez, Aljohn P.DateFixed Transport AllowanceActual Total FareFor ReimbursementTerritory: Taguig/ Makati/ Pateros. Pasay19-Jan240.00266.0026.00District: SOUTH LUZON/SOUTH GMA20-JanPeriod Covered: Jan 20-23, 201521-Jan22-Jan23-Jan24-JanTOTAL:26.00

Date of TripDayDestinationMode of TranspoFareTotalFromTo19-JanMondayResidence Imus BayanTRICYLE45.0045.00Imus BayanTaft, PasayBUS25.0025.00Taft, PasayCubaoMRT24.0024.00CubaoMarikina Valley HospitalFX25.0025.00Marikina Valley HospitalSt. Patrick HospitalJEEP7.007.00St. Patrick HospitalGood Shepherd PolyclinicJEEP7.007.00Good Shepherd PolyclinicSt. Anthony HospitalJEEP7.007.00St. Anthony HospitalTerminalTRICYCLE7.007.00TerminalCubaoFX25.0025.00CubaoTaft, PasayMRT24.0024.00Taft, PasayImus BayanBUS25.0025.00Imus BayanResidence TRICYCLE45.0045.000.00Prepared by:Approved by:____________________________________________________________________________________________(Signature over Printed Name)Immediate Superior

ER

FIELDMAN'S EXPENSE REPORTNAME: Alvarez, Aljohn P.PERIOD COVERED:TERRITORYEXPENSESFROM Jan 19 - Jan 30Taguig/ Makati/ Pateros/ PasayPAGE NO.1PLEASE CHECK CATEGORY OF EXPENSES:MARKETING EXPENSES (ACTIVITY EXPENSES THAT SHOULD BE APPROVED BY PRODUCT MANAGERS)

OPERATIONAL EXPENSES (FIELD EXPENSES CHARGE TO PCHC BUDGET)DATEDAYMOVEMENTXeroxFAXPARKING & TOLL FEESOFC SUPPLIESPOSTAGEINTERNET RENTALSOTHERS (Hosp ID)TOTAL EXPSUMMARY OF APPROVED EXPENSESPLACE(S) COVERED(For Accounting Use Only)27-JanTuesdaySan Juan de Dios Hospital, Pasay City1,000.001,000.00CODEAMOUNT27-JanTuesdayManila Adventist Medical Center500.00500.00GASOLINE1-FebSundayCellphone Load300.00300.00FARE0.0LODGING0.0MEALS & TRANPORT0.0REPAIR & MAINTENANCE0.0OFFICE SUPPLIES0.0AD & PROMOTIONS0.0TELEPHONE &0.0POSTAGE0.0OTHERS0.00.0GRAND TOTALPhp0.00.00.0Fieldman's explanation of OTHER EXPENSES
acumipig: acumipig:Pls. explain here your expensesex:XEROX-DCR/CallsheetFAX: S.OPrint: Memo of AscofMAIL: PCMOFC Supplies: Ballpen/folder0.00.0-0.00.00.00.00.0TOTAL EXPENSES:00000018001,800.00

ACCOUNTING/ BUDGET:AUDITING:

I CERTIFY THAT THE FACTS AND FIGURES CONTAINED IN THIS REPORT ARE TRUE AND CORRECT AND ALL THE EXPENSES REPORTED HEREINWERE INCURRED BY ME IN THE OFFICIAL PERFORMANCE OF MY DUTIES AND RESPONSIBILITIES TO THE COMPANY.

SUPERVISOR'S NAME & SIGNATURE : GUALBERTO MA. S. GUARDAREPORTED BY: Alvarez, Aljohn P.(IMPORTANT: THE REPORT WILL NOT BE PROCESSED WITHOUT THE SIGNATURE OF THE SUPERVISOR)

Lodging REQUEST FOR ADDITIONAL OUTSTATION ALLOWANCE (LODGING) PASCUAL LABORATORIES, INC.

Name of Employee SBUDesignationTerritoryRitz Neilven DizonPCHCBicol/Quezon

Lodging Date of TripDestinationPerson / Outlet To VisitNo. of NightsAllowanceAmount20-JanMarikina CityNaga City1350.00350.00

21-JanNaga City(encode hospitals/territorials)1350.00350.00

22-JanLegaspi(encode hospitals/territorials)1350.00350.00

23-JanNaga City(encode hospitals/territorials)1350.00350.00

26-JanDaet(encode hospitals/territorials)1350.00350.00

27-JanLucena(encode hospitals/territorials)1350.00350.00

28-JanLucena(encode hospitals/territorials)1350.00350.00

29-JanNaga City(encode hospitals/territorials)1350.00350.00

30-JanNaga City(encode hospitals/territorials)1350.00350.00

TOTAL93,150.00Total3,150.00

Date of RequestRequested ByApproved byPrcocessed ByChecked ByFeb. 2Ritz Neilven DizonDBMRSM

REQUEST FOR ADDITIONAL OUTSTATION ALLOWANCE (LODGING) PASCUAL LABORATORIES, INC.

Name of Employee SBUDesignationTerritoryPCHC

Lodging Date of TripDestinationPerson / Outlet To VisitNo. of NightsAllowanceAmount

TOTAL Total

Date of RequestRequested ByApproved byPrcocessed ByChecked ByDBMRSM

Summary of Hospital ID Reimburs#RITZ NEILVEN DIZON#CRISPINO PASUBILLOTERRITORY: BICOL/QUEZONTERRITORY: TONDO/BINONDO/MANILAHOSPITALADDRESSAMOUNTDATEOR#HOSPITALADDRESSAMOUNTDATEOR#1200.0024-Jan-1512345678901200.0024-Jan-15123456789022334455667788991010#ROBERT CHARLES MAGBUHOS#LEVIN VERGEL LIMJOCOTERRITORY: BATANGAS/LAGUNATERRITORY: SAN JUAN/MANDALUYONG/STA. MESAHOSPITALADDRESSAMOUNTDATEOR#HOSPITALADDRESSAMOUNTDATEOR#1200.0024-Jan-1512345678901200.0024-Jan-15123456789022334455667788991010#SONJA BARIA#ALJOHN ALVAREZTERRITORY: PARANAQUE/LAS PINAS/MUNTINLUPA/CAVITETERRITORY: MAKATI/TAGUIG/PATEROS/PASAYHOSPITALADDRESSAMOUNTDATEOR#HOSPITALADDRESSAMOUNTDATEOR#1200.0024-Jan-1512345678901San Juan De Dios HospitalPasay Citry1000.0027-Jan-1542422Manila Adventist Medical Center1975 Donada st. Pasay City50027-Jan-1582823334455667788991010#ARLENE CALINAOTERRITORY: MARIKINA/RIZAL UPTOWNS/PASIGHOSPITALADDRESSAMOUNTDATEOR#1200.0024-Jan-1512345678902345678910

AcknowledgementPASCUAL CONSUMER HEALTHCARE CORP.9TH FLOOR ETON CYBERPOD BLDG, EDSA COR. QUEZON AVE. QUEZON CITYAcknowledgement ReceiptThis is to acknowledge receipt of the following:

__________________________________Signature/ DesignationDate

Contact no:_________________

PASCUAL CONSUMER HEALTHCARE CORP.9TH FLOOR ETON CYBERPOD BLDG, EDSA COR. QUEZON AVE. QUEZON CITYAcknowledgement ReceiptThis is to acknowledge receipt of the following:

________________________________Signature/ DesignationDate

Contact no:__________________

PASCUAL CONSUMER HEALTHCARE CORP.

10TH FLOOR ETON CYBERPOD ONE BLDG, EDSA COR. QUEZON AVE. QUEZON CITYCASH RECEIPT

This is to acknowledge receipt from PASCUAL CONSUMER HEALTHCARE CORP. the amount of:25

P_____________________ as payment for _____________________________.

Activity:___________________________Venue___________________________

_____________________________________________Signature Over Printed NameDate(specify company name, if any)

Contact no:__________________

PASCUAL CONSUMER HEALTHCARE CORP.

10TH FLOOR ETON CYBERPOD ONE BLDG, EDSA COR. QUEZON AVE. QUEZON CITYCASH RECEIPT

This is to acknowledge receipt from PASCUAL CONSUMER HEALTHCARE CORP. the amount of:

P_____________________ as payment for _____________________________.

Activity:___________________________Venue___________________________

_____________________________________________Signature Over Printed NameDate(specify company name, if any)

Contact no:__________________

Gas

REIMBURSEMENT FOR FARE / GASOLINE EXPENSE

NAMEDESIGNATIONTBMTERRITORY

DATE OF TRIPDESTINATIONPERSON / OUTLET TO VISITNO. OF DAYS(FOR GASOLINE)FOR FARE REIMBURSEMENTBEG. KMEND KMTotal KM TravelledAmount

TOTAL9Liters consumed (Total KM travelled/9)Average Cost per liter/ Fare ExpenseTOTALLess: Daily Transpo AllowanceTotal Amount Due

Date of RequestSignature:Approved byProcessed byChecked by

DBM RSM

REIMBURSEMENT FOR FARE / GASOLINE EXPENSE

NAMEDESIGNATIONTERRITORY

DATE OF TRIPDESTINATIONPERSON / OUTLET TO VISITNO. OF DAYS(FOR GASOLINE)FOR FARE REIMBURSEMENTBEG. KMEND KMTotal KM TravelledAmount

TOTALLiters consumed (Total KM travelled/9)Average Cost per liter/ Fare ExpenseTOTALLess: Daily Transpo AllowanceTotal Amount Due

Date of RequestSignature:Approved byProcessed byChecked by

DBM RSM

car repair

Date:CRRF No.:CAR REPAIR REQUISITION FORM (CRRF)ADMINISTRATION DEPARTMENT

FOR REQUESTING CAR ASSIGNEE USE ONLY

REQUESTING UNIT/SECTION/DEPARTMENT/SBU:

CAR DETAILS:PLATE NO.MAKE TYPE:MODEL:KM Reading:

REQUESTED SERVICE CLASSIFICATION:

Car Repair

Car Maintenance

Others (specify)

JOB ORDER DESCRIPTION:

Prepared by/Date:Checked by/Date:Approved by/Date:Princes Fernando

Car AssigneeSupervisor/DBMDepartment/Division Head

FOR ADMINISTRATION DEPARTMENT'S USE ONLY

COST AND CAR REPAIRS & MAINTENANCE SCOPE OF WORKSAMOUNTACS/CASA

Total CostRemaining Budget:Over/Under

Remarks:

Evaluated by/Date:Checked & Recommended by/Date:Approved by/Date:

Admin Staff/SpecialistAdmin ManagerVP-Admin

CRRF-Revised 1/11