BUKTI PENGELUARAN DANA KAS KECIL

Diserahkan berdasarkan form permintaan kas bon kas kecil dengan nomor: ...................................

Diserahkan kepada :
Nama : .....................................................................................................................
Tanggal : .....................................................................................................................
Uang Sejumlah : Rp ................................................................................................................
Untuk Keperluan : .....................................................................................................................
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Yang menyerahkan, Yang Menerima,

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Kasir