Petty Cash Replenishment - Dartmouth College by liuqingyan


									                                          Petty Cash Replenishment                                              PYCARP

                                                   Sponsored Projects
                                       Cashier's Office * Hinman Box 6163 * 646-3014 * 646-2433
                                   DARTMOUTH COLLEGE * HANOVER * NEW HAMPSHIRE * 03755
                                     Checks Will Be Made Payable to the Petty Cash Custodian

Petty Cash Custodian:                                                                Org/Dept:

                                      ** To Be Completed by The Petty Cash Custodian **
    I (Custodian) request $ _______ to replenish my Petty Cash Fund. I certify that these expenditures were for valid College business

Signed:                                                                                      Date:

Print Name:                                                                          Hinman Box:

         Project (6)       Task (4)           Award (6)             Exp Type (5)        Org (3)                     Amount

   Attach receipts totaling this                                 Total Petty Cash To Be Replenished                                $0.00
       amount to this form.

                                                                 Plus: Actual Cash On Hand

                                                                     Equals: Total Petty Cash                                      $0.00

Approved By:                                                          Received By:

Print Name:                                                           Print Name:

Title:                                                               Title:

Date:                                                                 Date:

                        ** I acknowledge receipt of amount shown as Total Petty Cash To Be Replenished.**

Cashier's Initials:                                           Forwarded to Accounts Payable On:
          June 2007                             E-mail: Cashiers.Office@Dartmouth.EDU
             Instructions For Completing the Petty Cash Replenishment Form
Petty Cash Custodian: The employee's name in which the fund has been established.

Org/Dept: The Org or Department where the Fund resides.

                           ** To Be Completed by the Petty Cash Custodian **
$_________: Enter the amount of Funds you are requesting to replenish.

Signed: The Custodian must sign here certifying that the expenses were for valid Business purchases.

Date: Enter the date the Custodian signed certifying the expenses were for valid Business purchases.

Print Name: Print the Custodian's name.

PTAEO Chart String: Enter the five segment, 24 digit PTAEO Chart String where the funds should be expensed.

Amount: Enter the amount of the expense.

Total Petty Cash to Be Replenished: This Total should be the amount of receipts you have.

Actual Cash on Hand: Enter the total cash you currently have in your Petty Cash Box.

Total Petty Cash: Enter the total amount of your Petty Cash Fund.

Approved By : This request needs to be approved by the Custodian's immediate supervisor or more senior officer
having authority to approve charges to this PTAEO string.
Print Name: Print the name of the individual that approved this replenishment.

Title: Print the Approvers Title.

Date: Fill in the date that the individual approved the replenishment.

Print Name: Print the name of the individual that is receiving the cash.

Title: Print the title of the individual that is receiving the cash.

Date: Fill in the date that the individual is receiving the cash.

   ***Please be aware that Petty Cash Fund Replenishments being requested on Sponsored Project PTAEO
                          Chart Strings will have a check issued to the Custodian.***
    If you are charging the expenses to both PTAEO Chart Strings and GL Chart Strings, you will need to
 complete 2 Petty Cash Replenishment Forms, one for the Sponsored Project Expenses and one for the GL
 Expenses, and bring to the Cashier's Office. The Cashier's Office will disburse the funds for the GL Chart
String and will verify the expenses on the Sponsored Project PTAEO Chart String. The Cashier's Office will
then forward the Sponsored Project PTAEO Chart String Replenishment to Accounts Payable for a check to
                                                be issued.

 Should you have any questions regarding your Petty Cash Fund, please call the Cashier's Office at 646-2433
                                               or 646-3014

      June 2007                              E-mail: Cashiers.Office@Dartmouth.EDU
June 2007   E-mail: Cashiers.Office@Dartmouth.EDU

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