Appendix 63

REQUISITION AND ISSUE SLIP

Entity Name: DEPARTMENT OF AGRARIAN REFORM Fund Cluster: ____________

Division: ASEC - FASPO Responsibility Center Code:
Office: RIS No.:
Requisition Stock Available? Issuance
Stock No. Unit Item / Description Quantity Yes No Quantity Remarks
pcs Furniture Cleaner, aerosol, 300ml min./can 7
Box Envelope, Documentary, for A4 size document, 1
Box Envelope, Documentary, for legal size documen 1
Set Marker, Fluorescent, 3 colors per set 6
Pcs Insecticide, aerosol type, net content: 600ml mi 7
pcs Puncher, paper, heavy duty, with 2-hole guide, 2
Pcs Stapler, Standard Type, 200 staples min, 1 piece/box 2
Ream Paper, Multicopy, 80gsm, size: 210mm x 297m 15
Ream Paper, Multicopy, 80gsm, size: 216mm x 330m 15
Box Staple Wire, Standard 5
pad Notepad, Stick-on, 3x4, 100 sheets per pad 10
Pcs Air Freshener, aerosol, 280ml/150g min 7
pcs Calculator , Compact 12 digits 1
pcs Printer , BROTHER 1
xxxx nothing Followsxxxx

P.O. NO.:
SUPPLIER:
DR / SI NO.:

Purpose:

Requested by: Approved by: Issued by: Received by:

Signature
Printed Name UBALDO R. SADIARIN JR. GLORIA M. JULIANO
Designation ASEC-FAsPO Chief, GSD
Date:
DAR - QF-114 REV 00