PETTY CASH REIMBURSEMENT CLAIM FORM

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					                                                         PETTY CASH REIMBURSEMENT
                                                                CLAIM FORM
____________________________________________________________________________________________________________

Petty cash reimbursement is only up to the maximum of RM200.00. Any claims above RM200.00 will be paid via a cheque. Petty cash
can be reimbursed from the Finance Counter on every Mondays and Thursdays of the week.

       Routing: Staff member ---> HOD/HOS ---> Human Resources (medical only) ---> Director of Admin & Registrar ---> Finance

 Name:

 Dept/ School:


  No       Description                                                  Date             Receipt No               Total (RM)




                                                                                                    Total



 Ringgit:


 To be filled by Designated Signatory:

   Cost Centre Code:                                          Budgeted Account Code:


   Not Budgeted:                     Justification:



 Authorisation                              Name                                    Signature                        Date

 Prepared (Claimant)

 Verification (HOS/ HOD)

 Verification (Human Resources Dept)

 Authorisation for payment (Director of
 Administration and Registrar)

 Verification (Finance Dept)


 Received By                        Name                             Signature                        Date

 Claimant



Issuance Date: 1 Jan 2002                                       Issue No: 2                                             RO / 1006 / 02