Authority To Deduct Form

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AUTHORITY TO DEDUCT FORM

TO:_______________________________ COMPANY/BRAND:______________________

FROM:____________________________

DATE:_____________________________

I, _____________________________________, hereby authorized Payroll Department to deduct from my salary the


full amount of ____________requested if in case I failed to liquidate within Five (5) days after the completion of work
activity/purpose of _______ request/s. The said amount shall be deducted from my salary , payable
in_____terms/installment, starting ______________ to ______________ payout.

PARTICULARS/PURPOSE OF CASH ADVANCE REQUEST

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

AMOUNT IN WORDS
_________________________________________________________________________ (Php _____________)

Prepared by:

______Loise Andre’ Valdez____ ______08-30-23______

Signature over Printed Name Date


(Requestor)

Approved by:

_______________________________

Head of Department

Checked by: Noted by:

______________________________ _______________________

Accounting Staff/Supervisor Accounting Manager

Form No. HRD008 - FLT


New 05/15/2023

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