I CERTIFY THAT I have completed the travel authorized in the itenerary of
TRAVEL
Strictly in accordance with the appeared itenerary.
Cut short as explained below. Excess payment in the amount of ____
Was refund on OR No. __________dated _________
Extended as explained below. Additional itenerary was submitted. Explanation or jurisdiction_______________ Evidence of travel attached hereto- TRAVEL ORDER & CERTIFICATE OF APPEARANCE
Respectfully submitted:
MILDRED T. RAMIREZ Admin Aide III/Clerk 1
On evidence and information of which I have knowledge, the travel was