Sample Petty Cash Replenishment Form


Sample Petty Cash Replenishment Form
The petty cash holder lists the petty cash expenditures on a Petty Cash Replenishment Form
(PCRF) when he applies for replenishment of the petty cash fund (Sub-section 3.4.3).

The PCRF is in a set of two copies :
• the original copy attached to the Payment Voucher (PV) together with PCVs and supporting
  documents to apply for petty cash replenishment
• a copy filed in sequential order by the petty cash holder

                        petty Cash Replenishment Form
                          The Incorporated Owners of XXX Building
                                                                         pCFR No. ___________

   Date   PCV No. Payee     Minor          Stationary   Transportation   Others   Others    Total
                            HK$            HK$          HK$                                 HK$

   Total Expenditures

     PV No. :                   Checked by : ___________________________ _____________
                                              (name and signature)         (Date)
     Cheque No.                 Approved by : __________________________ _____________
                                                 (name and signature)              (Date)

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Tags: Filling, water
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