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REQUISITION AND ISSUE SLIP

_____________________________
Agency / Procuring Entity

Division/Branch/Unit Responsibility Center RIS No.


Office Code: SAI No.

REQUISITION ISSUANCE
STOCK
UNIT DESCRIPTION QTY. QTY. REMARKS
NO.

Purpose: ______________________________________________________________
______________________________________________________________________

Requested By: Approved By: Issued By: Received By:


Signature

Printed Name

Designation

Date

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