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Office/Agency
Date:
Municipality of Abucay ISSUANCE
Balance Requisition Stock Unit Total
on Number Value Value
Hand Qty. Unit Article Purpose Qty.
TOTAL
CERTIFIED: Supplies requisitioned are necessary and RECEIVED BY:
will be used solely purposes stated
VIVIAN Q. BENAMIR
Acting Municipal Treasurer
Name/Designation & Signature/Req.Officer
APPROVED BY: Date Received: ____________________
Filled by : _____________________
VIVIAN Q. BENAMIR
Acting Municipal Treasurer Packed by : _____________________
Name/Designation & Signature/Req.Officer Property Officer/Clerk:
DATE APPROVED:
Amount
Charged
__________
____________
____________
General Form NO. 33 (A)
(Revised September, 1947)
INVOICE AND RECEIPT OF ACCOUNTABLE FORMS
requisition
invoice
Officer's Requisition No. _______________ Accountable Forms
receive
Issuing Officer's Invoice No. ____________
Receiving Officer's Receipt No. _________ (Cross out words which do not apply)
requisition
invoice
I hereby the accountable forms above specified Requisition filled/received in the
receive
presence of ________________________________________________________________________________________
Prepared by:
VIVIAN Q. BENAMIR
Acting Municipal Treasurer
(Official Title)