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ANNEX A
WRIGHT NATIONAL HIGH SCHOOL
(Agency Name) CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS Pursuant to COA Circular No. 2017-001 dated June 19, 2017 Name of Employee MELODINA L. DACURO JRA. Employee No. Office WRIGHT NHS Division SDO-SAMAR Particular Amount (P) Meal for 1 participant (BREAKFAST/LUNCH/DINNER) 180 Snacks for 1 participant (AM/PM) 40 Fare *Mugdo-Hinabangan 15 *Hinabangan-Mugdo 15 *Mugdo-Hinabangan 15 *Hinabangan-Mugdo 15 TOTAL 280 Purpose: To attend the 2024 Division Schools Press Conference, Hinabangan Samar I hereby certify that the above expenses are incurred as they are necessary for the above-cited purpose, that above goods and services were acquired from parties not issuing receipts. And that I am fully aware that willful falsification of statement is punishable by law. Certified correct: Noted by: Signature Printed Name MELODINA L. DACURO JRA. GERONIMA G. CEBLANO, PhD Employee Immediate Supervisor Date: April 13, 2024 Date:
ANNEX A
WRIGHT NATIONAL HIGH SCHOOL
(Agency Name) CERTIFICATION OF EXPENSES NOT REQUIRING RECEIPTS Pursuant to COA Circular No. 2017-001 dated June 19, 2017 Name of Employee MELODINA L. DACURO JRA. Employee No. Office WRIGHT NHS Division SDO-SAMAR Particular Amount (P) Meal for 1 participant (BREAKFAST/LUNCH/DINNER) 180 Snacks for 1 participant (AM/PM) 40 Fare *Mugdo-Hinabangan 15 *Hinabangan-Mugdo 15 *Mugdo-Hinabangan 15 *Hinabangan-Mugdo 15 TOTAL 280 Purpose: To attend the 2024 Division Schools Press Conference, Hinabangan Samar. I hereby certify that the above expenses are incurred as they are necessary for the above-cited purpose, that above goods and services were acquired from parties not issuing receipts. And that I am fully aware that willful falsification of statement is punishable by law. Certified correct: Noted by: Signature Printed Name MELODINA L. DACURO JRA. GERONIMA G. CEBLANO, PhD Employee Immediate Supervisor Date: April 13, 2024 Date: