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Connecting Agro Value Chains (Private) Limited

ASSET ISSUANCE FORM


Function: Head-office to _____________________________

Date: / /

Section A: Issuee personnel and location details


Custodian of asset: Designation: Department/Location:

Section B: Asset identification and description (when issued from stores)


S. # Asset Identification Number Description Category
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Section C: Asset Transfer updates


S. # Asset Identification Number ATF Number Initials (IC)
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Section C: Approval of Issuance

Authorized signature Authorized signature


Name: Name:
Title: Title:
Date: Date:

Section D: Acknowlegement
I acknowledge receipt of the items referred in Section B above in
working condition and assume full responsibility of returning them in
the same condition.

Receiving Official Name and Signature


Date:

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