BORROWER’S SLIP BORROWER’S SLIP

Date: Date:
Control No. : Control No. :

Name: Office: Name: Office:

Address: Address:
Contact No.: Contact No.:
Item: Item:

Quantity: _____________ , Quantity: _____________,

(Figure) (Words) (Figure) (Words)
(Note: The borrower shall liable for any damage or loss of the borrowed items.) (Note: The borrower shall liable for any damage or loss of the borrowed items.)

Signature of Borrower Signature of Borrower

APPROVED: APPROVED:

CRISPIN S. LOPEZ CRISPIN S. LOPEZ

OIC-PGSO OIC-PGSO

RETURN SLIP RETURN SLIP

Returned by: Date: Returned by: Date:

(Name & Signature) (Name & Signature)

Inspected by: Date: Inspected by: Date:

(CIVIL SECURITY UNIT) (CIVIL SECURITY UNIT)

Remarks: Remarks:

Received by: Received by:

(PGSO REPRESENTATIVE) (PGSO REPRESENTATIVE)

Cc: File Cc: File

Civil Security Unit Civil Security Unit