Petty Cash

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					                                                    Petty Cash
           Used for Academic, Support, and Research Staff that have very small reimbursement requests.

           If the requests are more than $20 an Expense Reimbursement Form should be used.

           Graduate Students reimbursements are always put through on Expense Reimbursement Forms.

         Fill out details below
         Collect authorized signature(s) for accounting distribution and supervisor's signature
         Bring completed form to Nicole
         I will e-mail you once your petty cash reimbursement is ready for pick-up


 Employee ID

 E-mail address

 Speed code

 Account code & description


 Total amount to reimburse

_____________________________                                       ____________________________
1- Authorized Signature(s) for Accounting Distribution              Supervisor's Signature              Date

_____________________________                                       ____________________________
2- Authorized Signature(s) for Accounting Distribution              Supervisor's name (print)

_____________________________                                      ____________________________
Internal Control Approval – Sandra McFadyen      Date              Cash issued by: Nicole Leszczewski   Date

Cash reimbursement has been received.

__________________________________                                          ___________________
Claimant's Signature                                                                         Date
                                       For Reimbursement Please Contact:
                                                Nicole Leszczewski
                                 Room 520A, Chemical & Materials Engineering Building
                                                Ph: (780) 492-9384