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Date: ___________________
Account Number: _____________________
Account Name: _______________________
Amount Delete ($): ____________________

Reason for Delete:

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Cashier: _____________________ Batch Name: _________

Batch #: _____________
Prepared By: _____________________
Revenue Officer

Checked By: _____________________

Revenue Officer

Deleted By: ______________________

IT Officer

Approved By: _____________________

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