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Company Name: Document No:

Loko yusuf soft drink w.s OF/

trading
Title
Purchase Requisition Issue No. 1 Page 1 of 1
1
Effective Date:

Requested by (Div/Dept/Sec)

To be used for ______________________________ Cost Center____________________

Delivery expected before ____________________ Store Requisition No.__________

Item Description & Part Quantity

Unit Unit Price Total Price
No. Specification Number requested

1
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Prepared by Checked Approved by

Name ____________ Name_______________ Name______________
Sig.__ ________ Sig._____________ Sig._________
Date Date__________ Date_________

Date _______________________