Purchase Requisition Cum Verification Form

PR Number  
Requisitioner  Mukesh Yadav (To be filled by Purchase Executive)

PR Received Date
Employee Code   1166 (To be filled by Purchase Executive)
 
PR Date Mar 13, 2020 Project/Dept. Name  

Location / Gala Date of Email  Mar 13, 2020

No.  ATC    
To be filled by Requisitioner To be filled by Purchase Executive
Sr. Quantity Quantity Unit Estimated
No Item Description Required Available in stock To Order Price Price
USB - Wireless
1 Lan card 100 0 100
Gross
Note: Justification for the requirements (use additional sheet if needed) amount  
Taxes  
 D-Link DWA-131 Wireless Wifi Adapter USB Card

Business Continuity - Interim Plan - Work from Home

Verification to be done by TIFS after Item Received

Configuration Verification Other
Status(Ok/Not Ok) Verified by
Date levies  
     
     
 
 
 
 
 
       
       
         

To be filled by Finance Dept. To be filled by Purchase Executive

Requirements Yes No Finalized Supplier
Budgeted? Name:
  Address:
   

AT-FRM-FAC-PRF Page 1 of 2 Rev. No. 01

Rev. Date: 18.5.2015
 Purchase Requisition Cum Verification Form

Checked By Reviewed By  
Finance Finance Head Contact Tel. No
executive
         
         
         
Signature Date Signature Date  
  Recommended By Approved By Business Authorized by MD
(PM/TIFS) Head

Name      
Signature      
Date      

AT-FRM-FAC-PRF Page 2 of 2 Rev. No. 01

Rev. Date: 18.5.2015