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Please deduct the following amounts from Please deduct the following amounts from
my loan proceeds: my loan proceeds:
Sariling Sikap Loan Balance P Sariling Sikap Loan Balance P
_____________________________ _____________________________
(Signature Over Printed Name) (Signature Over Printed Name)
Division No.: _______ Division No.: _______
Station No.: _______ Station No.: _______
Employee No.: _________________ Employee No.: _________________
Date: _________________ Date: _________________
Please deduct the following amounts from Please deduct the following amounts from
my loan proceeds: my loan proceeds:
_____________________________ _____________________________
(Signature Over Printed Name) (Signature Over Printed Name)
Division No.: _______ Division No.: _______
Station No.: _______ Station No.: _______
Employee No.: _________________ Employee No.: _________________
Date: _________________ Date: _________________