FAMOUS RETAIL ILOCANDIA INC

Reimbursement/Liquidation/Replenishment Form

Name: Famous Ilocandia Retail Inc. Date:

Amount of Cash Advance (If any) or
Purpose: Office Supplies Petty Cash Fund:

Date Covered: Fund Used:

Amount
No. Date Vendor/Employee Article/Purpose Document No. With Receipt Remarks
Voucher only
Non VAT VAT Input VAT Total
1 9/6/2019 robinsons supermarket various materials SI#0000091842 681.12 81.73 762.85
2 9/6/2019 Silicon Valley Epson Ink SI#1883571 790.18 94.82 885.00
3 9/19/2019 ME shopping Center trash bin SI#1002/0446039 73.88 8.87 82.75
4 200.00 0.00 200.00
5 0.00 0.00
6 0.00 0.00
7 0.00 0.00
8 0.00 0.00
9 0.00 0.00
10 0.00 0.00
11 0.00 0.00
12 0.00 0.00
13 0.00 0.00
14 0.00 0.00
15 0.00 0.00
16 0.00 0.00
17 0.00 0.00
18 0.00 0.00
19 0.00 0.00
20 0.00 0.00
21 0.00 0.00
22 0.00 0.00
23 0.00 0.00
24 0.00 0.00
25 0.00 0.00
26 0.00 0.00
27 0.00 0.00
TOTAL 1,931.00 0.00

Excess -

Prepared by: Excess amount (Liquidation): ₱ None

Amount to cash card: ₱ 1,931.00

Transferred by:
Date Transferred:
Received/Checked by: Source of Fund:

Amount to payroll: ₱ 0.00

Audit/Finance Dept
Date: Transferred by:
Date Transferred: