Appendix 40

REPORT OF SUPPLIES AND MATERIALS ISSUED

For the Period ____________ to ___________, 20____

LGU: ___________________________________ Serial No. : ___________________

Fund: __________________________________ Date : ______________________

To be filled up by the Supply and/or Property Division/Unit To be filled up by the Accounting Division/Unit

Responsibility Quantity
RIS No. Stock No. Item Unit Unit Cost Amount
Center Code Issued

Recapitulation: Recapitulation:

Stock No. Quantity Unit Cost Total Cost Account Code

Posted by:
I hereby certify to the correctness of the above information.
_____________________________________________ __________________________ ______________
Signature over Printed Name of Supply and/or Signature over Printed Name of Date
Property Custodian Designated Accounting Staff