PRS No.

<name of requesting office>

______ Student Government
De La Salle University

<date of submission>

To: Accounting Office

Thru: Ms. Evelyn Esparrago

Director, Student LIFE

Kayne Litonjua
Executive Treasurer, University Student Government

From:<name of the person-in-charge>

<position name>
……………………………………………………………………………………….……………………

I would like to request the immediate release of <amount in words>, <amount in figures>, for
<purpose/s>.

The following were/are the expenses incurred/to be incurred:

Date/s Purpose/s Amount/s

Total ………………………………………………………………...... PhP XX,XXX.XX

Thank you for your immediate attention to this request.

Noted by:

<s>10
<n, p>
[of requesting office head]

10
<s> and <n, p> mean signature, name, position