Name of the Procuring Entity

Project Reference Number

Name of the Project
Location of the Project

Standard Form Number: SF-GOOD-61

Revised on: May 24, 2004

Standard Form Title: Requisition and Issue Slip

REQUISITION AND ISSUE SLIP

_____________________________
Agency / Procuring Entity
Division/Branch/Unit
Office

Responsibility Center
Code:

RIS No.
SAI No.

REQUISITION
STOCK
NO.

UNIT

ISSUANCE

DESCRIPTION

QTY.

QTY.

REMARKS

Purpose: ______________________________________________________________
________________________________________________________________
______
Requested By:
Signature
Printed Name
Designation
Date

Approved By:

Issued By:

Received By:

Name of the Procuring Entity

Project Reference Number

Name of the Project
Location of the Project