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TRIP TICKET Sample

This document is a driver's trip ticket from the Department of Justice in the Republic of the Philippines. It contains fields to record details of an authorized trip including the driver's name, vehicle information, authorized passenger, places visited, purpose of the trip, times of departure and arrival, distance traveled, gasoline and other supplies issued and consumed, and odometer readings. The driver and authorized passengers must sign to certify the accuracy of the recorded trip details.

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John Fran
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677 views1 page

TRIP TICKET Sample

This document is a driver's trip ticket from the Department of Justice in the Republic of the Philippines. It contains fields to record details of an authorized trip including the driver's name, vehicle information, authorized passenger, places visited, purpose of the trip, times of departure and arrival, distance traveled, gasoline and other supplies issued and consumed, and odometer readings. The driver and authorized passengers must sign to certify the accuracy of the recorded trip details.

Uploaded by

John Fran
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Justice

_____________
Date

DRIVER’S TRIP TICKET

A. To be filled by the Administrative Official Authorizing Official Travel:

1. Name of driver of the vehicle: ____________________________


2. Government car to be used, Plate No.______________________
3. Name of authorize passenger: ____________________________
4. Place or places to be visited/inspected: _____________________
5. Purpose______________________________________________

B. To be filled by the Driver:

1. Time of departure from Office/garage________________________________ AM/PM


2. Time of arrival at (per No. 4 above) _________________________________ AM/PM
3. Time of departure from (per No. 4) __________________________________AM/PM
4. Time of arrival back to garage/office_________________________________ AM/PM
5. Approximate distance traveled (to and from) ___________________________ AM/PM
6. Gasoline issued, purchased and consumed:

a. Balance in tank__________________________________liters
b. Issued by office from stock ________________________liters
c. Add-Purchased during trip_________________________liters
TOTAL___________________________________liters

7. Gear oil issued_____________________________________________________liters


8. Lub. oil issued_____________________________________________________liters
9. Greased issued ____________________________________________________liters
10. Speedometer readings, if any:
At beginning of trip____________________________________miles/kms
At end of trip _________________________________________miles/kms
Distance travelled (per 5 above)

11. Remarks: ____________________________________________________________


____________________________________________________________

I hereby certify to the correctness of the above statement of record of travel.

Regional Director

I hereby certify that I/we use the car/vehicle on official business state above.

(Authorized Passenger/Designation)

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