Barangay Amas

Barangay Amas
GASOLINE
GASOLINE
WITHDRAWAL SLIP
WITHDRAWAL SLIP

Date : _________________________ Date : _________________________

To : CATALA SERVICE CENTER To : CATALA SERVICE CENTER
QUANTITY ITEMS QUANTITY ITEMS
________ ltrs. ___ Gasoline ________ ltrs. ___ Gasoline
___ Fuel ___ Fuel

Vehicle Type : ____________________________ Vehicle Type : ____________________________

Plate Number: ____________________________ Plate Number: ____________________________
Equipment : ______________________________ Equipment : ______________________________
Purpose : TRAVEL Purpose : TRAVEL
________________________________________ ________________________________________
__ __
NELVIN P. NAVIAMOS NELVIN P. NAVIAMOS
Requesting Official Requesting Official

Approved by : HON. NELVIN P. NAVIAMOS Approved by : HON. NELVIN P. NAVIAMOS

Barangay Chairman Barangay Chairman
Received by : ________________________ Received by : ________________________

Barangay Amas Barangay Amas

GASOLINE GASOLINE
WITHDRAWAL SLIP WITHDRAWAL SLIP

Date : _________________________ Date : _________________________

To : CATALA SERVICE CENTER To : CATALA SERVICE CENTER
QUANTITY ITEMS QUANTITY ITEMS
________ ltrs. ___ Gasoline ________ ltrs. ___ Gasoline
___ Fuel ___ Fuel

Vehicle Type : ____________________________ Vehicle Type : ____________________________

Plate Number: ____________________________ Plate Number: ____________________________
Equipment : ______________________________ Equipment : ______________________________
Purpose : TRAVEL Purpose : TRAVEL
________________________________________ ________________________________________
__ __
NELVIN P. NAVIAMOS NELVIN P. NAVIAMOS
Requesting Official Requesting Official

Approved by : HON. NELVIN P. NAVIAMOS Approved by : HON. NELVIN P. NAVIAMOS

Barangay Chairman Barangay Chairman
Received by : ________________________ Received by : ________________________