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BULACAN STATE UNIVERSITY

San Jose Del Monte, Bulacan


MEMORANDUM RECEIPT

M.R #: __________________
Campus: Sarmiento Campus _________________________________
Classification: ____________
(Name of Accountable Officer)

Department: Date of Issuance:

I acknowledge to have received this equipment from ___________________________, Property


Custodian of Bulacan State University – Sarmiento Campus, the following equipment issued upon me and which
I am Accountable.

Serial # Unit Equipment Description Qty Acquisition Cost Property # Location Remarks
.

Received from: Issued to:

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