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LIQUIDATION FORM

Name : Position : Cut-off Date : Date of Transaction Amount Receipt # Date Filed : Department : Reason for Cash Advance :

*** To be filled up by Finance : Amount Cash Advance : _____________ Less : Total Amount Due : ___________ Total Amount : Requested by : Refund : _______ Approved by : Noted by : Finance Department : Date : Due to : ________

Employee's Signature : Direct Superior : Date : Date :

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