Date: ____________________
REQUISITION AND ISSUE VOUCHER
Recipient/Barangay: _______________________
ITEM QUANTITY UNIT ARTICLES/PARTICULARS
NO.
Purpose:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
CERTIFIED: All supplies received are in good
Supplies requisitioned are condition and fit for human
necessary and will be used solely for purpose/s consumption.
herein stated.
RECEIVED BY:
______________________________________ ________________________________
_ Signature over Printed Name
Name and Signature
Requesting Party/Representative _____________________________
Designation/Date
APPROVED BY:
MA. SOCORRO A. ROJAS
City Social Welfare and Development Officer