Purchase Requisition Form

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

Purchase Requisition Details

Requisition Number: {{requisition_number}}

Date of Request: {{date_of_request}}

Department/Unit: {{department_unit}}

Requested By: {{employee_name}} (Employee ID: {{employee_id}})

Purpose of Purchase

Please provide a brief explanation for this purchase request:

{{purpose_of_purchase}}

Items/Services Requested

Please list all items or services being requested. Attach additional sheets if necessary.

| Item No. | Description of Item/Service | Quantity | Unit Price ({{currency}}) | Estimated Total Price ({{currency}}) | Required By Date | Suggested Supplier(s) |

|----------|-----------------------------|----------|-----------------------|------------------------------------|------------------|-----------------------|

| 1 | {{item_1_description}} | {{item_1_quantity}} | {{item_1_unit_price}} | {{item_1_total_price}} | {{item_1_required_by}} | {{item_1_supplier}} |

| 2 | {{item_2_description}} | {{item_2_quantity}} | {{item_2_unit_price}} | {{item_2_total_price}} | {{item_2_required_by}} | {{item_2_supplier}} |

| 3 | {{item_3_description}} | {{item_3_quantity}} | {{item_3_unit_price}} | {{item_3_total_price}} | {{item_3_required_by}} | {{item_3_supplier}} |

Total Estimated Cost: {{total_estimated_cost}} {{currency}}

Budget Information

Budget Account Number: {{budget_account_number}}

Budget Line Item: {{budget_line_item}}

Available Budget: {{available_budget}} {{currency}}

Authorisation

I confirm that this purchase is necessary for company operations and is within the allocated budget.

Requested By (Employee Signature): _________________________ Date: {{employee_signature_date}}

Approved By (Manager Name): {{manager_name}}

Manager Signature: _________________________ Date: {{manager_signature_date}}

Department Head/Director Approval (if required - amount exceeding {{approval_threshold_amount}} {{currency}}):

Name: {{department_head_name}}

Signature: _________________________ Date: {{department_head_signature_date}}

Procurement Department Use Only

Purchase Order Number: {{purchase_order_number}}

Date Issued: {{po_date_issued}}

Supplier Confirmed: {{supplier_confirmed}}

Delivery Date Confirmed: {{delivery_date_confirmed}}

Procurement Officer: {{procurement_officer_name}}

Signature: _________________________ Date: {{procurement_officer_signature_date}}

Terms and Conditions

1. All purchases must be in compliance with the company's procurement policy.

2. Any deviation from approved suppliers or specifications must be formally justified and re-approved.

3. This requisition does not constitute a purchase order until formally approved and processed by the Procurement Department.

Signature Block

_________________________ _________________________

Authorised Signatory Date