ANNEX “C”

Republic of the Philippines

REGIONAL TRIAL COURT
Third Judicial Region
Province of Aurora
Branch 90 (101)
ITINERARY OF TRAVEL
(FOR VOUCHER PREPARATION)

NAME: JESSIE F. SERNADILLA CIVIL CASE NO. 2018-11-1504

POSITION: Process Server OR No.: 8364990
DATE: Nov. 21, 2018

Purpose of Travel: Service of Court Processes

[ ] Summons with complaint/Petition [ ] TROs/Decision
[/ ] Subpoena/Notices/Notice of Hearing [ ] Notice of Garnishment
[ ] Preliminary Citation/Preliminary Pre-Trial Order [ ] Levy of Goods/Chattel/Property
[ ] Writ of: Replevin [ ] [ ] Posting
Execution [ ] [ ] Notice of Sheriff’s Fee
Possession [ ] [ ] Notice of Special Raffle
Attachment [ ] [ ] As directed by the Court
Habeas Corpus [ ] [ ] Others (please specify)
[ ] Temporary Protection Order [ ]
[ ] Permanent Protection Order [ ]

Date Place of Origin Place of Destination Name of Person Depart- Arrival Means of AMOUNT
to be Served ure Time Transport-
Time ation
6-14-19 -from RTC-Suklayin, -PAO Office, Baler, -Atty. Raul D. 9:00 9:15 tricycle 17.00
Baler, Aurora Aurora GalaGala
-from PAO Office,
Baler, Au. -Brgy. 2, Baler, Aurora -Atty. Laila Aurora 9:30 9:45 tricycle 14.00
-from Brgy. 2, Baler, -RTC-Baler, Aurora A. Reopta
Aurora 10:50 11:00 tricycle 17.00
-from Residence at -Brgy. Bianoan,
7-2-19 Suklayin, Baler, Casiguran, Aurora -Erwinia Villegas, 5:00 9:15 motorcycle 556.00
Aurora (101 kms. more or less, et al., (pls. see (gasoline)
one way) notice of hearing)
-from Bianoan, -Brgy. Calangcuasan, -Danny M. Villar 10:35 11:20
Casiguran, Au. Casiguran, Aurora
-from Calangcuasan, -Res. at Purok 7, 1:30 6:00
Casiguran, Aurora Suklayin, Baler, Au.
(123 kms. more or less,
one way)
Total 604.00
Per Diem Allowance/Meal allowance, etc. 396.00
GRAND TOTAL Php1,000.00
I hereby certify that I have personally prepared the foregoing
Itinerary of Travel which is necessary to accomplish the above-
stated purpose and that the period/time covered is reasonable
and the expenses claimed are proper.

_________________________________ Recommending Approval:

Signature

July 22, 2019 DONNA M. NAYVE-LOPEZ

Date Clerk of Court/OIC

Approved by:

MAXIMO B. ANCHETA, JR.

Executive Judge
 Guidelines on the Payment, Collection and Liquidation
of Travel Expenses Under Sec. 10, Rule 141 (Travel Expenses
of Sheriffs, Process Servers and Other person serving Processes)

ANNEX “D”

Republic of the Philippines

Supreme Court
DISBURSEMENT VOUCHER
Agency
MODE OF PAYMENT No.:

Date
MDS Check Commercial Bank ADA Others
Payee/Office: JESSIE F. SERNADILLA TIN/Employee No. OS/BUS No.
Date:
Responsibility Center
Title: Code:
Particulars Amount
To payment of traveling expenses incurred while on official business on June 14, 2019
from RTC-Suklayin, Baler, Aurora to PAO Office, Baler, Aurora (Atty. Raul D. GalaGala);
to Unit 3, 2nd Floor, BG Plaza, Barangay 2, Baler, Aurora (Atty. Laila Aurora A. Reopta)
and back to RTC-Suklayin, Baler, Aurora and on July 2, 2019 from Residence at Purok 7,
Barangay Suklayin, Baler, Aurora to Barangay Bianoan, Casiguran, Aurora (Erwinia
Villegas, et al.,); to Brgy. Calangcuasan, Casiguran, Aurora (Danny M. Villar); and back to
Residence at Purok 7, Barangay Suklayin, Baler, Aurora, re: Service of Notice of Hearing
under Civil Case No. 2018-11-1504, for: Recovery of Possession with Damages----------- Php1,000.00

Amount Due Php1,000.00

A. Certified: [ ] Supporting documents complete and proper B. Approved for Payment
[ ] Cash Available
[ ] Subject to ADA (where applicable)

Signature: _____________________________ Signature: ____________________________

Printed Name: JESSIE F. SERNADILLA Printed Name: DONNA M. NAYVE-LOPEZ

Position: (Sheriff, Process Server or Authorized Court Personnel) Position: (Clerk of Court/OIC)

Date: July 22, 2019 Date: July 22, 2019

C. Received Payment D. Journey Entry Voucher

Check/ADA No.:
Signature: _____________________ Date: _______________ Date: No.
Bank Name: Date:
Printed Name: JESSIE F. SERNADILLA OR No./Other relevant document
Issued:
 Guidelines on the Payment, Collection and Liquidation
of Travel Expenses Under Sec. 10, Rule 141 (Travel Expenses
of Sheriffs, Process Servers and Other person serving Processes)

ANNEX “F”

Republic of the Philippines

REGIONAL TRIAL COURT
Third Judicial Region

STATEMENT OF ACTUAL TRAVEL EXPENSES INCURRED*

RTC-Branch 1-FC
Court/Station No.;________________ Date: ______________
Case No.: 2019-03-1536
Barangay Suklayin, Baler, Aurora Nature: Declaration of Nullity of Marriage
(Address)

PARTICULARS AMOUNT

Payment of Services for Court processes:

[ /] Summons with complaint/Petition
[ ] Subpoena/Notices/Notice of Hearing
[ ] Preliminary Citation/Preliminary Pre-Trial Order Php1,000.00
[ ] Writ of: Replevin [ ]
Execution [ ]
Possession [ ]
Attachment [ ]
Habeas Corpus [ ]
[ ] Temporary Protection Order (TPO)
[ ] Permanent Protection Order (PPO)
[ ] TROs/Decision
[ ] Notice of Garnishment
[ ] Levy on Goods/Chattel/Property
[ ] Posting
[ ] Notice of Sheriff’s Fee
[ ] As directed by the court
[ ] Others (please specify)

Total Actual Expenses Incurred (For details, please see itinerary of travel) Php1,000.00

Requested by: Approved by:

CRIS N. GONZALES MAXIMO B. ANCHETA, JR.

(Sheriff, Process Server or Authorized Court Personnel) (Executive Judge)

August 28, 2019 August 28, 2019

(Date) (Date)

*This form shall be used for all transactions involving the service of court processes in the item listed above.
 ANNEX “G”

Republic of the Philippines

REGIONAL TRIAL COURT
Third Judicial Region
Baler, Aurora

CERTIFICATE OF TRAVEL COMPLETED

Supreme Court RTC-Branch 90 (101)

(Agency Head) Official Station

I certify that I have completed the travel authorized in Itinerary of Travel No. ______
dated June 14, 2019 & July 2, 2019 under conditions indicated below.

[ ] Strictly in accordance with the approved itinerary.

[ ] Cut short as explained below. Excess payment in the amount of ____________ was
refunded on C.A. No. ______________ dated _______________.

[ ] Extended as explained below. Additional Itinerary was submitted.

[ ] Other deviation as explained below.

Explanation or justification:

Evidence of travel attached hereto: Receipt (gasoline); Copy of Notice of Hearing and
Certificate of Appearance and Tricycle Fare, Baler,
Aurora

Respectfully submitted:

JESSIE F. SERNADILLA
Process Server

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

DONNA M. NAYVE-LOPEZ
Clerk of Court-Officer-in-Charge
 Guidelines on the Payment, Collection and Liquidation
of Travel Expenses Under Sec. 10, Rule 141 (Travel Expenses
of Sheriffs, Process Servers and Other person serving Processes)

ANNEX “B”

Republic of the Philippines

Regional Trial Court
Third Judicial Region
Baler, Aurora

STATEMENT OF ESTIMATED TRAVEL EXPENSES

Regional Trial Court, Br. 90 (101)
(Court Station) No. _____________Date: October 18, 2018
Suklayin, Baler, Aurora Case No.: 2018-04-1430
(Address) Nature: Correction of Entries
PARTICULARS AMOUNT
Payment of Services for Court Processes
[ ] Summons with complaint/Petition
[/] Subpoena/Notices/Notice of Hearing Php1,000.00
[ ] Preliminary Citation
[ ] Writ of: Replevin []
Execution []
Possession []
Attachment []
Habeas Corpus [ ]
[ ] Temporary Protection Order (TPO)
[ ] Permanent Protection Order (PPO)
[ ] TROs/Decision
[ ] Notice of Garnishment
[ ] Levy on Goods/Chattel/Property
[ ] Posting
[ ] Notice of Sheriff’s Fee
[ ] Notice of Special Raffle
[ ] As directed by the Court
[ ] Others (please specify)

Total Estimated Expenses (For details, please see itinerary of travel) Php1,000.00

Requested: Approved by:

JESSIE F. SERNADILLA HON. MAXIMO B. ANCHETA, JR.

(Sheriff, Process or Authorized Court Personnel) (Executive Judge)

October 19, 2018 October 23, 2018

(Date) (Date)

This form shall be used for all transactions involving the service of court processes in the items above.