Date:______________________________BARYA:__________________ PESO LITERPREMIUM : _________________ ____________DIESEL :__________________ ____________DIESEL :__________________ ____________PREMIUM :__________________ ____________Total :P. Reading :_________________________Total :Calibration:_________________________SALES:A/R:_________________________CASHSALE :BARYA:_________________________

SALES :_________________________

COLLECTION:________________________

Expenses :_________________________

VALE:_________________________

REMIT:_________________________TOTAL :CASH:_________________________Diff.:

PAUTANG:

COLLECTION: ________________________

SALES: ______________

CALIBRATION:PREMIUM 1: _______________DIESEL 1 :_______________DIESEL 2 :_______________PREMIUM 2:_______________

TANK MEASUREMENT:AMPMPREMIUM1:____________ ____________DIESEL :_______________ ____________PREMIUM 2:____________ ____________

VALE :__________________

NAMEAMOUNT SIGNATURE

EXPENSES: ______________

PremiumDieselPremium

T

Y

Premium1Diesel 1Diesel 2Premium 2

Total:

Premium 1DieselPremium 2

TANK

PUMP

Difference

Remit :___________________NAME AMOUNT SIGNATURE

DENOMINATION

START END

1000

500

200

100

50

10

5

1

.25

TOTAL

CASHIER:____________________