FORM # 03

Quality Control Form for Goods Received

Originating WRMO Purchase

Office: Request No:

Originating Unit: Date: Day Month Year

The following items of delivered good are commented or rejected:

S/N Goods delivered* Quantity Objection on goods Rejected Accepted

* All goods delivered for above mentioned Demand Purchase Request is of acceptable standard (if no objections made in
table above) and Finance Units is requested to process final payment.

The above quality control was made by;:………………………Position:…………….……Date:………………Signature:

The above quality control was made by;:………………………Position:……….…………Date:………………Signature:

Instructions by LM/AMr to responsible for store: