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Petty Cash

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Application For Petty Cash - Instructions

DATE OF APPLICATION:

The date you are filling out the form.

DEPARTMENT

We would like to have as much information on file as possible to identify the area the petty cash is being held in. At present, there are a number of funds in the same "Department", ie. 17 different Psychiatry funds in different locations. Any distinguishing name (project/person) would be appreciated, ie. Department - Financial Services, Sub-Department - Accounts Receivable, or Department - Psychiatry, Project - ABC

LOCATION

Full Campus or Off-Campus mailing address of where the funds are being held .

IMPREST HOLDER

Name, phone number, email address and signature of the individual who will be holding and disbursing the funds.

DEPARTMENTAL APPROVAL

Name, phone number, email address and signature of individual approving the administering of funds by the imprest holder.

ACCOUNT NUMBER FAS

Account number of the responsible department so that a commitment can be entered on the system.

AMOUNT APPLIED FOR

Float/Fund the department is applying for.

FUNDS PREVIOUSLY RECEIVED

To be used if you are applying for an increase in funds, i.e. you previously had $60 and you're applying for an additional $40 to increase your funds to $100. Enter the $40 as "Amount Applied For" and the $60 on this line.

REASON FOR THIS APPLICATION

State the purpose why you need a petty cash float.

ALL LINES BELOW THE REASON FOR THIS APPLICATION ARE FOR THE USE OF FINANCIAL SERVICES ONLY. PLEASE RETURN THE COMPLETED FORM TO Lolita Reyllo-Zarzuela, DTC 413. IF YOU HAVE ANY QUESTIONS, PLEASE CALL EXTENSION 27568 OR 23654.

A CHEQUE AND FURTHER PETTY CASH FUND ADMINISTRATION PROCEDURES WILL BE FORWARDED TO THE IMPREST HOLDER ON APPROVAL OF THE APPLICATION.

PLEASE INFORM FINANCIAL SERVICES OF ANY CHANGES IN THE INFORMATION GIVEN.