Unitatea

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| DISPOZIIE DE*)
PLATA
CTRE CASIERIE |
|
nr din .
|
| Numele i prenumele
| Funcia (calitatea)
| lei
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(n cifre)
(n litere)
|
| Scopul ncasrii - |
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Viza de control
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Compartiment
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|Conductorul unitii| financiar-preventiv | financiar-contabil |
| Semntura |_____________________|_____________________|____________________|
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|___________|_____________________|_____________________|____________________|
*) Se va nscrie "NCASARE" sau "PLAT", dup caz
14-4-4
A6
t2

(verso)
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DATE SUPLIMENTARE PRIVIND BENEFICIARUL SUMEI:
|
| Se completeaz |
|
| numai pentru
| Actul de identitate CI Seria nr.. |
| pli
| Am primit suma de lei
|
|
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(n cifre)
|
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Data
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Semntura ....................
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|________________|___________________________________________________________|
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CASIER
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| Pltit/ncasat suma de lei
|
|
(n cifre)
|
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|
Data .
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Semntura ....................
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