Cash Verification Form

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CASH VERIFICATION FORM
Date
Activity
Chairperson
Budget category
Coins
X
.01
=
X
.05
=
X
.10
=
X
.25
=
X
.50
=
X
1.00
=
Total 1 $
Currency
X
$1.00
=
X
$5.00
=
X
$10.00
=
X
$20.00
=
X
$50.00
=
X
$100.00
=
Total 2 $
Checks
How many?
(Attach itemized list)
Total 3 $
Cash Box Reimbursement (change/petty cash)
Total 4 $
Grand Total (Total 1 + Total 2 + Total 3 - Total 4) $
FOR MEMBERSHIP DUES COLLECTION ONLY
#_______ members @ $__________ (dues) = $__________+ donations $________ - petty cash $_________= $_____________
Please note: This total should equal the above Grand Total.
Verification: (signature of the two counters) The undersigned certify these funds were received and properly accounted for.
Signature
Signature
FOR TREASURER’S USE ONLY
Amount received: $
Date received:
Date deposited:
Treasurer’s Signature
Date
Note: After the treasurer verifies and deposits funds, he or she should provide a copy of the deposit slip to the person who submitted the funds.
Georgia PTA everychild.onevoice.
124
Leadership Resource Guide 2008-2009

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