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Republic of the Philippines Republic of the Philippines

Office of the Punong Barangay Office of the Punong Barangay


Pamucutan, Zamboanga City Pamucutan, Zamboanga City
_____________________________
FUEL ISSUE SLIP FUEL ISSUE SLIP
(Order Slip) (Order Slip
TO THE FUEL MAN: Plate No._________________ TO THE FUEL MAN: Plate No._________________

Please Issue _________liters of ______________ to the bearer Please Issue _________liters of ______________ to the bearer
___________, Barangay Personnel, deductible/charge ___________, Barangay Personnel, deductible/charge

(Name of Office/Barangay) (Name of Office/Barangay)

Purchase Order No.: _____________ Php. _______________ Purchase Order No.: _____________ Php. _______________

Requested by: Approved by: Requested by: Approved by:

_______________________ ROBERTO V. CARPIO _______________________ ROBERTO V. CARPIO


Duly Authorized Officer Name of Punong Barangay Duly Authorized Officer Name of Punong Barangay
(Signature over Printed Name) (Signature over Printed Name)

Issued by: Received by: Issued by: Received by:

____________________ ___________________ ____________________ ___________________


Duly Authorized Officer Duly Authorized Officer
(Signature over Printed Name) (Signature over Printed Name)

Note: PLEASE ATTACHED FUEL SLIP per receipt withdrawn. Note: PLEASE ATTACHED FUEL SLIP per receipt withdrawn.
Republic of the Philippines Republic of the Philippines
Office of the Punong Barangay Office of the Punong Barangay
Pamucutan, Zamboanga City Pamucutan, Zamboanga City
_____________________________ _____________________________________
FUEL ISSUE SLIP FUEL ISSUE SLIP
(Order Slip) (Order Slip)

TO THE FUEL MAN: Plate No._________________ TO THE FUEL MAN: Plate No._________________

Please Issue _________liters of ______________ to the bearer Please Issue _________liters of ______________ to the bearer
___________, Barangay Personnel, deductible/charge ___________, Barangay Personnel, deductible/charge

(Name of Office/Barangay) (Name of Office/Barangay)

Purchase Order No.: _____________ Php. _______________ Purchase Order No.: _____________ Php. _______________

Requested by: Approved by: Requested by: Approved by:

_______________________ ROBERTO V. CARPIO _______________________ ROBERTO V. CARPIO


Duly Authorized Officer Name of Punong Barangay Duly Authorized Officer Name of Punong Barangay
(Signature over Printed Name) (Signature over Printed Name)

Issued by: Received by: Issued by: Received by:

____________________ ___________________ ____________________ ___________________


Duly Authorized Officer Duly Authorized Officer
(Signature over Printed Name) (Signature over Printed Name)

Note: PLEASE ATTACHED FUEL SLIP per receipt withdrawn. Note: PLEASE ATTACHED FUEL SLIP per receipt withdrawn.

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