VPF-FIN-AB-F-002

Revision Status/Date 0 : 18Feb20

REQUEST FOR PAYMENT FORM

Date Requested: Date Received by Finance:

Type of Expense: CAPEX OPEX Others: (pls specify)

Department: CASH MANAGEMENT Charge To (Per Budget Item):

Branch: NU MANILA

Petty Cash Fund Regular Expense

Cash Advance (P2K & below) With Purchase Order, PO No.
Reimbursement No Purchase Order Reimbursement
Liquidation (Attach summary listings) Cash Advance (Above P2K) Liquidation
Others, pls specify______________ Others, pls specify______________
Note: For PCF Advances, liquidation must be within 24 hours from release of fund. For Friday and Sat., the liquidation is on Monday.
Payee:

ROLANDO ORIAS JR
Amount in words Amount

FOUR THOUSAND ONE HUNDRED SIXTY EIGHT AND 46 CENTAVOS

4,168.46
Date Needed For Liquidation Purposes Only
Purpose: CA Amount
Actual Expense _______________
TEMPORARY CASHIER SALARY TERM 3 AY 2020-2021
Net Amount Due Return Money/ Refund
Ref# __________________________
CA Date
For Cash Advance Purposes Only - Authority to Deduct
This will authorize deduction of the above amount from my payroll in case I failed to liquidate the said amount after five (5) days after the event
date. Conforme:
Signature Over Printed Name
Prepared by : Recommending Approval by: Approved by: Budget Approval by:

GRACELYN ALCANTARA
Sign Over Printed Name Sign Over Printed Name Sign Over Printed Name Sign Over Printed Name