PRS No.

<name of requesting office>

______ Student Government
De La Salle University

<date of submission>

To: Accounting Office

Thru: Br. Bernard S. Oca

Vice Chancellor for Lasallian Mission and External Relation

Ms. Fritzie De Vera

Dean, Student Affairs

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 are the expenses to be incurred:

Date/s Purpose/s Amount/s

Total ………………………………………………….……………...... Php XX,XXX.XX

Noted by:

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

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