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CAS - Vendor Information Form
PCSO CAS information form for vendor
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PCSO-F-ITS-SWG003
INFORMATION TECHNOLOGY SERVICES DEPARTMENT
DATE :
DEPARTMENT:
DIVISION:
______________________ Time:_______________________
_________________________________________________
_________________________________________________
REQUESTED BY:
_________________________________________________
Printed name and signature
___
TRANSACTION
TYPE
VENDOR
DETAILS
( * - required)
New [ ]
Update [ ]
*Vendor Name:_________________________________________________________
*Payee : ______________________________________________________________
*Contact Person: _______________________________________________________
Position: _____________________________________________________________
*Address
Apt. Unit: _____________________________ Street: ____________________________
Brgy./Village: ____________________________________________________________
City: _____________________________ Municipality: ___________________________
Province: _____________________________ Region: ___________________________
Zipcode: ______________________________
*Email: ______________________________ Phone: ____________________________
Fax: ________________________________
*TIN No:
[
][
][
]-[
][
][
]-[
][
][
]-[
][
][
]
*Payment Terms: ________________________
*VAT [ ]
Withholding Tax (WTAX) Code - % :
_______ - ___%
*NON-VAT [ ]
Expanded Value Added Tax (EVAT) Code - %: _______ - ___%
*AP Class Code: ____________ *Default Expense Account: _______________________
(OF, CF or PF)
Checked By:
(ABD Personnel from
Operating Fund AP,
Charity Fund AP or
Prize Fund AP
Division)
Service By:
(ITSD Personnel)
__________________________
Name and Signature
________________________________
Name and Signature
Noted By:
(ITSD – ODM)
________________________________
RENE M. RELUCIO
OIC - Department Manager III
________________________
Date/Time
_______________________
Date/Time
_______________________
Date/Time
