REQUEST FOR CASH ADVANCE FORM
Name: _______________________________ Date: _________________
Position: _____________________________
Amount Requested: ___________________ Needed on: ____________
Reason: _____________________________________________________
_____________________________________________________
______________________________________________________
Requested by: ___________Noted: __________ Received by: _________
Employee’s Sign Dept. .head Date: ______________
This portion to be filled by the payroll master only:
Amount Amt. of
Salary Current Loan Amount Amortized Ded./month
Total: Total:
In %:
Payroll Master Date
AUTHORITY TO DEDUCT
I, ___________________________________, hereby authorize the company to deduct
the amount of ____________________/month for the period of _________________ as
payment for my requested cash advance amounting to ___________________________.
Please start the deduction on __________________ ending on ____________________.
Approved by:
__________________________________ _______________________
Employee’s Signature over printed name
Date : ______________