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Appendix 63
REQUISITION AND ISSUE SLIP
Entity Name : CHED RO1 Fund Cluster : ______________________
Division : ________________________________ Responsibility Center Code : ______
Office : _________________________ RIS No. : RIS2025-00400
Stock No. Unit Description Quantity Stock Available? Issue
Yes No Quantity Remarks
2692 PACK RECHEARGEABLE BATTERY WITH CHARGER, 2800MAH, AA, 4 pieces per pack 5 / 5
337 CART INK , EPSON C13T664100 (T6641), BLACK 1 / 1
338 CART INK , EPSON C13T664200 (T6642), CYAN 1 / 1
339 CART INK, EPSON C13T664300 (T6643), MAGENTA 1 / 1
340 CART INK, EPSON C13T664400 (T6644), YELLOW 1 / 1
Purpose: FOR MIS UNIT USE
Requested by: Approved by: Issued by: Received by:
Signature:
Printed Name: SHELDONNE ROSARIO NYMPHA N. BUENIO RICKY A. CERA
Designation: LA UNION Chief, Administrative Officer Supervising Administrative Officer/ Supply Officer
Date: 2025-09-11