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RER Form
BLGF form for reimbursement expese receipt
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: REIMBURSEMENT EXPENSE RECEIPT
Entity Name:
BUREAU OF LOCAL
GOVERNMENT FINANCE
Fund Cluster : Regular Agency Fund
Date :
December 6, 2018
RER No. :
RECEIVED from ______________________________________
(Name)
_________________________________________________ the amount
(Official Designation)
of __________________________________________ (P__________)
(In Words)
(in Figures)
in payment for _______________________________________________
(Payments for subsistence, services,
_________________________________________________________
rental or transportation should show inclusive dates,
_________________________________________________________
purpose, distance, inclusive points of travel, etc.)
PAYEE
Name/Signature __________________________________________
Address ________________________________________________
WITNESS
Name/Signature __________________________________________
Address ________________________________________________
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