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The document consists of reimbursement expense receipts revised in January 1992, detailing payments made to Myrna B. Roman for various expenses. Each receipt includes the date, amount, purpose of payment, and signatures of the payee and witnesses. The receipts document transportation and documentary stamp expenses related to submissions to the Bureau of Internal Revenue (BIR) on specific dates.

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GAAM Vol.II GAAM Vol.

II
Revised January 1992 Revised January 1992

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT

Date No. Date No.

Received from_ Received from_

(Name) (Name)

_the amount _the amount

(Official Designation) (Official Designation)

of_____________________________________(P____________) of_____________________________________(P____________)
(In Words) (In Figures) (In Words) (In Figures)

in payment for _ in payment for _

(Payment for subsistence,services, (Payment for subsistence,services,
______________________________________________________ ______________________________________________________
rental or transportation should show inclusive dates, rental or transportation should show inclusive dates,
______________________________________________________ ______________________________________________________
purose,distance,inclusive points of travel,etc.) purose,distance,inclusive points of travel,etc.)

PAYEE PAYEE

Name/Signature________________________________________ Name/Signature________________________________________
Address_______________________________________________ Address_______________________________________________
Residence Cert. No._____________________________________ Residence Cert. No._____________________________________
Place of Issue__________________________________________ Place of Issue__________________________________________

WITNESS WITNESS

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT

Date ### No. Date ### No.

Received fromMYRNA B. ROMAN_ Received fromMYRNA B. ROMAN_________

(Name) (Name)

_OIC - Provincial Accountant__the amount_ _OIC - Provincial Accountant__the amount_

(Official Designation) (Official Designation)

ofFifty Five Pesos______________(P_55.00__)_ ofFifty Pesos______________(P_50.00)

(In Words) (In Figures) (In Words) (In Figures)

in payment for __ transportation expenses incurred for the____ in payment for __ transportation expenses incurred for the____
(Payment for subsistence,services, (Payment for subsistence,services,
submission of Income Payor/Withholding Agent's Sworn Declaration submission of Income Payor/Withholding Agent's Sworn Declaration
rental or transportation should show inclusive dates, rental or transportation should show inclusive dates,
to BIR on December 12, 2024 (From Capitol to BIR & vice-versa)____ to BIR on November 15, 2024 (From Capitol to BIR & vice-versa)____
purose,distance,inclusive points of travel,etc.) purose,distance,inclusive points of travel,etc.)

PAYEE PAYEE

WITNESS WITNESS

aration

rsa)____
GAAM Vol.II GAAM Vol.II
Revised January 1992 Revised January 1992

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT

Date 8/14/2024 No. Date 9/12/2024 No.

Received fromMYRNA B. ROMAN_ Received fromMYRNA B. ROMAN_________

(Name) (Name)

_OIC - Provincial Accountant__the amount_ _OIC - Provincial Accountant__the amount_

(Official Designation) (Official Designation)

ofThirty Pesos______________(P_30.00) ofThirty Pesos______________(P_30.00)

(In Words) (In Figures) (In Words) (In Figures)

in payment for __ documentary stamp incurred for the____ in payment for __ documentary stamp incurred for the____
(Payment for subsistence,services, (Payment for subsistence,services,
submission of Income Payor/Withholding Agent's Sworn Declaration submission of Income Payor/Withholding Agent's Sworn Declaration
rental or transportation should show inclusive dates, rental or transportation should show inclusive dates,
to BIR on August 14, 2024 ____ to BIR on September 12, 2024 ____
purose,distance,inclusive points of travel,etc.) purose,distance,inclusive points of travel,etc.)

PAYEE PAYEE

WITNESS WITNESS

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GAAM Vol.II GAAM Vol.

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT

Date No. Date No.

Received from_________________________________ Received from_________________________________

___________________________________________the amount ___________________________________________the amount

in payment for _________________________________________ in payment for _________________________________________

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT

Date ### No. Date ### No.

Received from______MYRNA B. ROMAN___________ Received from______MYRNA B. ROMAN___________

_____OIC - Provincial Accountant__________the amount_______ _____OIC - Provincial Accountant__________the amount_______

of____Fifty Five Pesos____________________(P___55.00____)___ of____Fifty Pesos____________________(P___50.00____)____

REIMBURSEMENT EXPENSE RECEIPT REIMBURSEMENT EXPENSE RECEIPT

Date 8/14/2024 No. Date 9/12/2024 No.

Received from______MYRNA B. ROMAN___________ Received from______MYRNA B. ROMAN___________

_____OIC - Provincial Accountant__________the amount_______ _____OIC - Provincial Accountant__________the amount_______

of____Thirty Pesos____________________(P___30.00____)____ of____Thirty Pesos____________________(P___30.00____)____

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Received from_ Received from_

_the amount _the amount

in payment for _ in payment for _

Received fromMYRNA B. ROMAN_ Received fromMYRNA B. ROMAN_________

_OIC - Provincial Accountant__the amount_ _OIC - Provincial Accountant__the amount_

ofFifty Five Pesos______________(P_55.00__)_ ofFifty Pesos______________(P_50.00)

Received fromMYRNA B. ROMAN_ Received fromMYRNA B. ROMAN_________

_OIC - Provincial Accountant__the amount_ _OIC - Provincial Accountant__the amount_

ofThirty Pesos______________(P_30.00) ofThirty Pesos______________(P_30.00)