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Supplier'S Statement of Account

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SUPPLIER'S STATEMENT OF ACCOUNT

Supplier's Name : ______________________ Date Covered : _______________________ ____________________ Original Qty (kgs) Date of Payment : Date of Transaction

Item Description

Net Qty (kgs)

Amount

Over All Total Amount Paid

Prepared by : Printed Name over Signature Date :

Approved by : Printed Name over Signature Date :

Received by :

Supplier's Name over Signature Date :

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