REQUISITION SLIP

Control No: 2011_______

Date: ________________

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Please furnish the following materials/items to______________________________________

Barangay _________________________for __________________________________________
_

Unit Quantity Descriptions Amount:

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Charge to the Municipality of Bambang. Thank you very much.

Account Code: OTHER EXPENSES

Requested by:

___________________________ ____________________________ _________________________

___________________________ ____________________________ _________________________

With Allocation: Approved:

LOPITO LLOYD T. VALDEZ ARNEL WENCESLAO Z. HERNANDEZ

Secretary to the Sanggunian Municipal Vice-Mayor/Pres.Officer

Received by:

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Signature over Printed Name