Petty Cash Settlement Form - Northern Michigan University

ADVERTISEMENT

PETTY CASH SETTLEMENT FORM – NORTHERN MICHIGAN UNIVERSITY
FUND CUSTODIAN
_________________________________________________
_________________________
Last Name
First Name
M.I.
NMU IN
Note: Fund Custodian is the individual authorized on the Petty Cash Fund Request Form.
TYPE OF TRANSACTION
_____ Close out of Petty Cash Fund – no check to be reissued
_____ Reimbursement needed – check to be issued to Fund Custodian
LIST OF PURCHASES
Date
Purchased From
Description of items purchased
Amount
(Attach receipts)
________
_______________________
____________________________
________
________
_______________________
____________________________
________
________
_______________________
____________________________
________
________
_______________________
____________________________
________
________
_______________________
____________________________
________
________
_______________________
____________________________
________
________
_______________________
____________________________
________
________
_______________________
____________________________
________
________
_______________________
____________________________
________
Total amount purchased
________
Cash on hand or cash deposited at Financial Services to close out fund (if applicable)
________
Cash short (over)
________
Total Petty Cash Fund
________
ACCOUNT DISTRIBUTION INFORMATION
ACCOUNTING USE ONLY
Organization # - Account #
Amount
1099 Code
______________-__________
_________
Voucher #
$
______________-__________
_________
Invoice #
______________-__________
_________
Document ID #
______________-__________
_________
Vendor ID #
______________-__________
_________
$
TOTAL
______________________ _______ __________
________________________________________
FUND CUSTODIAN
DATE
TELEPHONE #
DESCRIPTION
__________________________________________
________________________________________
DEPARTMENT NAME
REFERENCE #
______________________________
__________
___________________
______________
Audit
Date
APPROVED BY FINANCIAL MANAGER
DATE

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go