Consumable Request Form

UAC OF NIGERIA PLC REQUISITION FORM FOR COMPUTER CONSUMABLES

REQUISITIONING DIVISION/DEPT DATE NAME OF AUTHORISED PERSON TO COLLECT DESIGNATION

S/NO. DESCRIPTION OF ITEM QTY REQUIRED QTY SUPPLIED QTY BALANCE 1. 1 Part Paper Ruled 1 2. 2 Part Paper Ruled 2 3. 3 Part Paper Ruled 3 4. 4 Part Paper Ruled 4 5. 1 Part Plain Paper 5 6. 2 Part Plain Paper 6 7. 3 Part Plain Paper 7 8. 1 Part Plain Computer Payslip 8 9. Month End Payslip 9 10. Management Salaries Payslip 10 11. LX 300 Ribbon 11 12. DFX 9000 Ribbon 12 13. LQ 2170/2180 Epson Ribbon 13 14. Tally Ribbon 6218 14 15. Tally Ribbon 6100 15 16. Printout Binders (Big) 16 17. Printout Binders (Small) 17 18. LBP 810 Toner Cart. 18 19. LaserJet Toner 5L/6L 19 20. LaserJet Toner 1100 20 21. LaserJet Toner 1200 21 22. LaserJet Toner 1300 22 23. LaserJet Toner 1320 23 24. LaserJet Toner P2015 (53A) 24 25. LaserJet Toner 2055D (05A) 25 26. LaserJet Toner 4100N 26 27. LaserJet Toner 4050N 27 28. LaserJet Toner 4200 28 29. LaserJet Toner 4250 (42X) 29 30. LaserJet Toner CB540A (Black) 30 31. LaserJet Toner CB541A (Cyan) 31 32. LaserJet Toner CB542A (Yellow) 32 33. LaserJet Toner CB543A (Magenta) 33 34. HP Ink Cartridge Coloured (78) 34 35. HP Ink Cartridge Black (45) 35 36. Ink Cartridge 56A Black 36 37. Ink Cartridge 57A Coloured 37 38. 1513 Ink Black 38 39. 1513 Ink Coloured 39 40. DeskJet Ink (27A) 40 41. DeskJet Ink (28A) 41 42. DVD Rewritable 42 43. DVD Recordable

44. Rewritable CD 43 45. Recordable CD 44 46. PS/2 Mouse 45 47. Serial Mouse 46 48. USB Mouse 47 49. Mouse Pad 48 50. 2GB Flash Drive 49 51. 3M Patch Cable 50 52. 5M Patch Cable 51 53. Printer Cable (Parallel) 52 54. USB Printer Cable 53 55. 20/40GB Tape Cartridge 54 56. 72GB Tape Cartridge 55 57. 8 Port Switch 56 58. 5M Line Cord 57 59. 2 Way Adaptor 58 60. Modular Socket 59 61. LaserJet Toner 4600 (20A) Black 60 62. LaserJet Toner 4600 (21A) Cyan 61 63. LaserJet Toner 4600 (22A) Yellow 62 64. LaserJet Toner 4600 (23A) Magenta 63 65. LaserJet Toner 2025DN (CC530A) Black 64 66. LaserJet Toner 2025DN (CC531A) Cyan 65 67. LaserJet Toner 2025DN (CC532A) Yellow 66 68. LaserJet Toner 2025DN (CC533A) Magenta 67 69. 1.5 Terabyte HDD

70. 2.0 Terabyte HDD

71. Rack Mountable Surge Protection Extension APPROVED BY: NAME OF AUTHORISING MGR SIGNATURE AND DATE

*NB: Please print back & Front on a sheet of paper.