LAVENDER SHELL SERVICE STATION

BORROMEO ST., SURIGAO CITY

TEL/FAX NO. (086) 826-6224, 232-5220

STATEMENT OF ACCOUNT
As of : March to May 2017

TO : PEEDMO
ADDRESS :
NO. OF UNIT
DATE INVOICE NO. REFERENCES DEBIT CREDIT BALANCE
LITERS PRICE
Gasoline
27-Nov-17 Diesel 35 ltrs. 39.61
28-Nov-17 Gasoline 6
29-Nov-17 Gasoline 6
30-Nov-17 Gasoline 6
1-Dec-17 Gasoline 6
4-Dec-17 Gasoline 6
5-Dec-17 Gasoline 6
6-Dec-17 Gasoline 6
7-Dec-17 Gasoline 6
8-Dec-17 Gasoline 6
11-Dec-17 Gasoline 6
12-Dec-17 Gasoline 6
13-Dec-17 Gasoline 6
14-Dec-17 Gasoline 6

AMOUNT IN WORDS: SIX THOUSAND FIVE HUNDRED NINETY THREE PESOS

Received Statement of Account in the amount of

Prepared by: Checked by: Certified Correct By:

________________________
MARY JOY S. PAGON ROSELLE A. QUIBLAT LUZ B. VENDER
Account Officer Station In-charge Retailer
Date: May 16, 2017
Received by:

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SIGNATURE Over Printed Name
Date: