REQUEST FORM

REQUEST FORM
( ) Items ( ) Labor
Branch: KABACAN HIGHWAY 2__ To: ASSISTANT OPERATIONS MANAGER ( ) Items ( ) Labor
Department: ________OPERATION_________ Branch: KABACAN HIGHWAY 2 ___________________To: ASSISTANT OPERATIONS MANAGER
Department: __________OPERATION ______
Concerns/Explanations: _____________BOND PAPER____________________________________________
Concerns/Explanations: ____________________________________________________________________
Item/s requested:
Item/s requested:
Description Qty. Date of Last Purchase Serial No. of Defective Item (if applicable)
Description Qty. Date of Last Purchase Serial No. of Defective Item (if applicable)
__________________ ________ ______________________ ____________________________
________________________ ______ _______________ ___________________________________
___________________ _________ ______________________ _____________________________
_________________________ _____ _________________ ___________________________________
____________________ ___________ ________________________ _____________________________
_________________________ ______ __________________ ____________________________________
Requested by ;______________CABALLERO,QUEEN QUEEN________________/ Designation __________OIC_____ / Date ;_________
Requested by: ____ CABALLERO QUEEN QUEEN_____ / Designation _______ OIC ___________ / Date ______________
Noted & checked by: ___ZOREN M.LINES____/ Designation ________BM/SA________/ Date _______________
Noted & checked by: ___ZOREN M. LINES__________/ Designation __________BM/SA__ / Date ;__________
Findings and evaluation:___________________________________________________________
Findings and evaluation: ____________________________________________________________
Recommendation: _________________________________________________________________
Recommendation: ____________________________________________________________________
Recommended/ Pre-approved by: ____ ____________________/ Designation AREA SUPERVISOR______ / Date ______________
Recommended/ Pre-approved by: ____ ____________________/ Designation AREA SUPERVISOR______ / Date __________________
Item/s for purchase:
Item/s for purchase:
Item/s Name Qty. Unit Unit Cost Amount Supplier
Item/s Name Qty. Unit Unit Cost Amount Supplier

Total: _____
Mode of acquisition: ( ) Cash ( ) Local Purchase ( ) Petty Cash
Total: ________
Mode of acquisition: ( ) Cash ( ) Local Purchase ( ) Petty Cash
Approved by: __________________________________________________/ Designation __________AOM_______________ / Date ____________________
Approved by: __________________________________________________/ Designation __________AOM_______________ / Date ____________________
Prepared by: ___________________________________________________/ Designation __________________________ _ / Date ____________________
. Prepared by: ___________________________________________________/ Designation __________________________ _ / Date ____________________
Item/s provided to the requester:
Item/s provided to the requester:
Item/s Name Qty. Serial Number Asset Tag No.
Item/s Name Qty. Serial Number Asset Tag No.

I confirm that the above item/s and its corresponding description/s is/are true and correct. I witnessed that the above item/s I confirm that the above item/s and its corresponding description/s is/are true and correct. I witnessed that the above item/s
were installed and working properly the time I affixed my signature were installed and working properly the time I affixed my signature
Received by: __________CABALLERO ,QUEEN QUEEN/ Designation _____ OIC____________/ Date ______________ Received by: __________CABALLERO,QUEEN QUEEN/ Designation _____ OIC___________________ / Date ____________________