Form 200
SOUTH AFRICAN HERITAGE RESOURCES AGENCY
PAYMENT REQUISITION FORM
PROVINCE: ___________________________
DATE: ______________________________
________________________________________________________________________________________
Please settle the following account(s) and debit the division and budgeting votes as indicated below:
Supplier
Purpose
Source document
Amount
AC no.
Prepared by: __________________________
Date:_____________________________
Admin. Assistant
Reviewed by: _________________________
Date: _____________________________
Provincial Manager
Checked by: __________________________
Date: _____________________________
Finance Officer
NB: THIS COVERING SHEET MUST BE SUBMITTED TO THE HEAD OFFICE FOR ALL
PAYMENTS.