MSU Main Batch ‘76

Batch Assistance Program

(BAP)

Disbursement Request

Date: 22,
April, Disbursement No.
2021
Payee:
SUSAN
ROQUE
DADOLE
Address: ZONE 3, BAYBAY, Linangcayan, Naawan, Misamis Oriental
Mobile:
09189422 Email/FB:mswdo9022initao@gmail.com
077
Purpose /Special Instructions:
Assistance for BAP member SUSAN ROQUE DADOLE who is hospitalized at
Manticao General Hospital due to COVID 19. She would like it sent via remittance
centers like PALAWAN, ML or the likes addressed to her daughter TESSA ANN
DADOLE BAYRON.

Requested by: Approved by:

(Sgd.)Preciosa A. Dimaporo Beverly Faith T. Tanggol

Regional Coordinator Lead Convenor

PAYMENT DETAILS
Fund Source:
Date of payment: Amount: Php
Words in Pesos:
Mode of payment and transaction reference no.
Released by: Received by: (if handed personally)

Flordelyn C. Cannu
National Finance Officer
Recipient/Representative