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Republic of the Philippines

Department of Education
Region XIII- CARAGA
East District III Division of Butuan City
East Butuan District III
BASAG NATIONAL HIGH SCHOOL
Basag, Butuan City
___________________________________________________________________________________
Cash Request
Amount Requested :___________________________________________
Date Requested :___________________________________________
Purpose :___________________________________________

Requested by:
______AIZA C. GOC-ONG
COOPERATIVE TREASURER

Approved by:
TEOFILO A. TANJAY JR.
COOPERATIVE MANAGER

Acknowledgment Receipt
Date:_____________

Received from:___________________

I, ______________________, hereby acknowledge that I have received the following cash amount
from the cooperative:

Amount Received :______________________________________________________


Purpose/Description of Payment : _____________________________________________________
_____________________________________________________
Date and Time of Receipt : _____________________________________________________

Received By: ________________


Signature:___________________

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