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880 A.S. Fortuna Street, Banilad
                           Mandaue City 6014, Cebu, Philippines
                           Tel (+6332) 343 8883 Ω Fax (+6332) 344 3572
                                                                                       Date Requested
                                                                                         Date Needed
                                                 REQUEST FOR PAYMENT

                           PAY TO :AY TO :
                           P


                                                                                  A
                                                                                  Amount in Figuresmount in Figures
        Amount in Words:



        Payment for:.                                                              Responsibility Center










        Requested by:                                      Reviewed by:            Approved by:

        _____________                               ___________________





                           880 A.S. Fortuna Street, Banilad
                           Mandaue City 6014, Cebu, Philippines
                           Tel (+6332) 343 8883 Ω Fax (+6332) 344 3572
                                                                                       Date Requested
                                                                                         Date Needed
                                                 REQUEST FOR PAYMENT

                           PAY TO :


                                                                                   Amount in Figures
        Amount in Words:




        Payment for:.                                                              Responsibility Center










        Requested by:                                      Reviewed by:            Approved by:

        _____________                               ___________________
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