Petty Cash Form

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Physics Department Petty Cash - Signed Receipt of Refund
Reimbursed Date: ___/___/___ Date on Receipt: ___/___/___ Cash received by:________________________
↑Please print ↑
Total amount reimbursed: $____________ Signature of Reimbursed: _________________________________
↑ Please sign ↑
Reimbursement description: __________________________________________________________________
33 digit account number to post to: ______-_________-________-___________-________-________-_______
tub
org
object
fund
activity
subactivity
root
Approved by: __________________________
• The purpose of a petty cash refund is to provide a TUB or organization with an amount of money sufficient to cover minor expenditures.
• Petty cash is intended to simplify the reimbursement of staff members and visitors for small expenses, such as taxi fares, postage, office
supplies and other incidentals.
• Travel, entertainment, and other reimbursements over $50.00 should be processed through the Travel Office.
• Petty cash funds may NOT be used to pay invoices for goods or services, to pay salaries or wages, or to make advances or loans to
employees or others.
* The above form is writeable, except for the signature line.
* Each form can only have one receipt - receipts may not be combined together on to one form.
* Print out the tax exempt certificate @ and present it to the vendor
prior to your purchase.
tub
org
object
fund
activity
subactivity
root
Approved by: __________________________
• The purpose of a petty cash refund is to provide a TUB or organization with an amount of money sufficient to cover minor expenditures.
• Petty cash is intended to simplify the reimbursement of staff members and visitors for small expenses, such as taxi fares, postage, office
supplies and other incidentals.
• Travel, entertainment, and other reimbursements over $50.00 should be processed through the Travel Office.
• Petty cash funds may NOT be used to pay invoices for goods or services, to pay salaries or wages, or to make advances or loans to
employees or others.

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