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Date
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Department
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Ministère
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Financial
Code (Interdepartmental Settlement Code)
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Code
financier (Code de règlement interministériel)
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Deliver
to
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Livrer
à
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Name
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Nom
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Telephone
no.
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No
de téléphone
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Address
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Adresse
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Building
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Room
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Immeuble
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Pièce
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Total
no. of Original Pages
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Number
of Copies per original
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Nbre
total de pages originales
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Nombre
de copies par original
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Additional
Instructions/Instructions supplémentaires
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Please
bill this organisation for the following additional copies
(155 for the House of Commons and
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____
for the Depository Services Program)
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Veuillez
facturer les exemplaires additionnels (155 pour la Chambre
des communes et
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____
pour le Programme des services de dépôt) à cette organisation.
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Government
of Canada Report on Plans and Priorities /
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Rapport
sur les plans et les priorités du gouvernement du Canada
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No.
of Copies Requested (No Charge) / Nbre d'exemplaires commandés (sans
frais) __________
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Financial
signing authority (Certified that funds are available pursuant to Section
32(1) FAA)
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Signature
autorisée en matière financière (Attestation de la disponibilité des
fonds aux termes du par. 32(1) (LGFP)
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Name/Nom
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Title/Titre
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Signature
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