Uva Wellassa University

Advance Payment Voucher

Name of the Officer Requesting Advance :	Account Code :
Designation :	Cheque No :
Division :	Voucher No :

Section – A

Please grant a sum of Rs. :	In Words :
Name of the Expenditure/ Project Name/ Vote :
To be utilized for the under mentioned program/ Procurement :

No.	Item Description	No. of items (if applicable)	Unit Price (if applicable)	Total Value Rs.
1
2
3
4
5
Total

I agree to settle the advance immediately on completion of program/ procurement or within a period of 30 days whichever comes first

Signature of the Requesting Officer	Date

Section – B

Recommendation

I have carefully examined the expenditure items, rates etc. and have made necessary alterations as shown above the request recommended.

Amount Requested	Rs. :
Amount Recommended	Rs. :
Recommend by
Date (DD/MM/YY)

Section – C

Payment Approved by
Signature of the Approving Officer	Date
Payment Certified by
Signature of the Certifying Officer	Date

Section – D

Received a sum of Rs.:	In Words :
Signature of the Requesting Officer	Date