Proforma invoice ICM Industries Established since 1999 7 of 73 Capital Hill Commercial Park Capital Hill C/O Le Roux St & K101 Midrand South
Payment is to be made between 9.30 A.M. to 12.30 P.M.. 1. Fee for issuing a
duplicate of : (a) Diploma }. (b). Degree. } Rs.600/- (after 10 years Rs.1,000/-).
Address (street, city, zip):. Day Phone Number: Evening Phone Number: Dates of Request: From: ... FOR OFFICE USE ONLY. V
PHONE: ... Meeting/Seminar. Memorial Service. Concert/Recital. Special Program. Reception ... *There is no fee for wired
Yes. No. Would you mind staying in a house with pets? Yes ______ No ______. If yes, what kind of pets? Are you allergic
Signature: Required. VA EDUCATION BENEFIT to be used in certification on VA 22-1990 form (As APPLIED for VA EDUCATION BE
Use this form to request a driving record. We will ... record(s) to you or to the
individual or company you request below. Mail this ... DR-500-009 (R/11/12)WA.
voter: a current utility bill, bank statement, government check, paycheck, or other ... The status of your absentee requ
Computer Lab Request Form ... Do you plan to lecture in the computer lab? ...
Middlefork 226. 21. Hayes. 101. 22. Hayes. 105. 14. Hayes. 115. 37. Hayes. 127.
Vehicle Request & Invoice Form ... TYPE OF VEHICLE REQUESTING: TYPE OF
... PLEASE PREPARE JOURNAL VOUCHER/PAYMENT TRANSFERRING THE ...
Clear Form
University of Hawai`i at Hilo Auxiliary Services/Motor Pool Office
Vehicle Request & Invoice Form REQUESTING PROGRAM:
TODAY'S DATE:
CONTACT PERSON:
PHONE:
EMERGENCY CONTACT PERSON:
PHONE:
REQUESTED PICK-UP DAY/DATE:
PICK-UP TIME:
RETURN DAY/DATE:
RETURN TIME:
DESTINATION/TRAVEL PLAN:
NUMBER OF PASSENGERS:
TYPE OF VEHICLE REQUESTING:
TYPE OF CARGO
AUTHORIZED DRIVERS: FULL NAME
#
LICENSE#
STATE
EXP DATE
1) 2) CAMPUS CODE/ACCOUNT CODE PAYMENT METHOD:
ESTIMATED CHARGES: - hrs x
rate = $
AUTHORIZED DRIVERS ARE DETERMINED TO BE COMPETENT OPERATORS FOR THIS VEHICLE AND WILL FOLLOW THE CONDITIONS AT www.uhh.hawaii.edu/auxsvc/ motorpool/policy.php. I ALSO CERTIFY THERE ARE SUFFICIENT FUNDS TO PAY FOR THIS VEHICLE USAGE.
APPROVING AUTHORITY SIGNATURE
TYPED NAME
TITLE
FOR MOTOR POOL OFFICE USE ONLY DATE/TIME RECEIVED:
INVOICE NO.:
APPROVED/DISAPPROVED:
ASSIGNED VEHICLE LIC #:
INSTRUCTIONS: FOR BUSINESS OFFICE PLEASE PREPARE JOURNAL VOUCHER/PAYMENT TRANSFERRING THE FOLLOWING AMOUNTS FROM THE RESPECTIVE ACCOUNT INDICATED ABOVE TO THE VEHICLE MAINT.ACCT.#2-2189__(0701) VEHICLE TYPE
