Requisition and Issue Voucher: (Provincial Treasurer

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General Form No. 45.

(A)
(Revised) January. 1945)
REQUISITION AND ISSUE VOUCHER

(PROVINCIAL TREASURER No. _____________


To the (PROPERTY CLERK, bureau of __________________________________ ____________________, _____
(Date)
Sir Please furnish the following supplies:

REQUISITION AS ISSUED
Balance
on
Hand QTY. Unit Article Purpose QTY Stock Unit Price Total Value Account
Number Charged

I CERTIFY that the supplies requisitioned above ______________________________, 20_____


are necessary and will be used solely for the purposes (Date)
stated. Received the supplies above as issued

______________________________ ________________________________
(Requisition Officer) (Signature of person receiving supplies)

______________________________ ___________________________
(Title) (Designation)

APPROVED: filled by ___________________________________


Packed by _________________________________
______________________________ Shipped to _________________________________
(Signature) Bill of Lading No. _______________Date ________

______________________________ ___________________________________
(Title) Property Clerk
Note – Requisitioner must invariably cross out
all spaces not used below last article requisition (See
__________________,_______ instruction No. 2)

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