No.

REQUEST FOR CASH ADVANCE ( CA ) FORM

DATE: ACKNOWLEDGEMENT OF CASH RECEIPT
EMPLOYEE NO: Amount
EMPLOYEE NAME: Date
APPROVED AMOUNT Received by:
( printeed full name and signature )

Amount in Words: Note: PCF is subject to surprise count. A cash count shall be performed without
an advance notice.

PURPOSE

REQUESTED by: APPROVED by:

( Signature & ( Signature & Date
Date )
Requestor Name Approver's Name
Designation/Position Designation/Position
AUTHORITY TO DEDUCT
If I failto liquidate the full amount entrusted to me, I hereby authorize the company to deduct the full amount of
unliquidated amount from my salary.

( Requester's printed full name & signature ) / date

No.

REQUEST FOR CASH ADVANCE ( CA ) FORM

DATE: ACKNOWLEDGEMENT OF CASH RECEIPT
EMPLOYEE NO: Amount
EMPLOYEE NAME: Date
APPROVED AMOUNT Received by:
( printeed full name and signature )

Amount in Words: Note: PCF is subject to surprise count. A cash count shall be performed without
an advance notice.

PURPOSE

REQUESTED by: APPROVED by:

( Signature & ( Signature & Date
Date )
Requestor Name Approver's Name
Designation/Position Designation/Position
AUTHORITY TO DEDUCT
If I failto liquidate the full amount entrusted to me, I hereby authorize the company to deduct the full amount of
unliquidated amount from my salary.
( Requester's printed full name & signature ) / date
NOTE: RECEIPT/