Panama Collections Management Form
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ScribdTranslationsPanama Collections Management Form
Uploaded by
ScribdTranslationsREPUBLIC OF PANAMA
Collections Management
Institution Consecutive Number
(For Official Use) (For Official Use)
Payment Order Number
(For Official Use)
National Treasure
Institutional Fund
(Fund Name)
In favor of
Name Supplier Code
ID card or RUC Telephone
Nombre del Representante Legal
Signature of the Legal Representative ID card
Endorse in the name of Endorsement date
DETAIL JUSTIFYING THE CHARGE VALORES EN BALBOAS
(Description of the good or service provided)
Purchase Order No.
Gross Value
Contract No. Less
Retention for Guarantee ( %)
Addendum No. Advance ( %)
More
Agreement No. ITBMS
SUME 911
Resolution No. Excise Tax on Consumption
Less
Invoice(s) Number:
Retention of % of ITBMS
Total Amount to Collect Total Value in
in letters Number
SIGNATURES AND SEALS BY RECORDS AND INSTITUTIONAL AUTHORIZATION
TREASURY STAMP BUDGET STAMP
RECEIVED
ACCOUNTING SEAL AUTHORIZATION
Company:
Nombre:
ID card:
Accounting Document Number: Cargo:
SIGNATURE, STAMPING AND SEALS OF THE GENERAL CONTROLLER OF THE REPUBLIC
SEAL(S) OF INSPECTION ENDORSEMENT
Refrendata
NOTICE: FREE FORM / SHOULD BE FILLED OUT PREFERABLY ON A COMPUTER / WILL NOT BE ACCEPTED WITH CROSSINGS OUT OR STRIKETHROUGHS OR ALTERATIONS
STANDARDIZED STRUCTURE
