PETTY CASH FUND BALANCE CONFIRMATION - denvergov.org · PETTY CASH FUND BALANCE CONFIRMATION _____...
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PETTY CASH FUND BALANCE CONFIRMATION Required Fields Instructions Read all instructions prior to completing this form. Per Fiscal Accountability Rule 3.2 – Petty Cash, this form is to confirm the Petty Cash amount, Petty Cash Fund Custodian, and address where the department or agency houses the Petty Cash Fund. Complete and sign the form. In the address field, include the department or agency number. Note: No stamped or electronic signatures will be accepted. A handwritten signature is required. Questions about this form or process? Email [email protected]. To avoid processing delays do not leave any field blank. It is important to include the department or agency number in the address. First Name: __________________________ M.I.: ___ Last Name: _______________________ Supplier ID: DENVR _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ Department or Agency: __________________________________________________________ Address: ________________________________ City: _______ State: ___ Zip Code: ________ A Petty Cash Fund in the amount of $ ___________________, is retained at the above listed location. Petty Cash Fund By signing below, I certify the information provided above on this form is true, accurate, and complete. Petty Cash Fund Custodian Signature: _________________________________ Date: __________ Return Return the form by email to [email protected]. Questions? Email [email protected].
Transcript of PETTY CASH FUND BALANCE CONFIRMATION - denvergov.org · PETTY CASH FUND BALANCE CONFIRMATION _____...
PETTY CASH FUND BALANCE CONFIRMATION
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Read all instructions prior to completing this form.
Per Fiscal Accountability Rule 3.2 – Petty Cash, this form is to confirm the Petty Cash amount, Petty Cash Fund Custodian, and address where the department or agency houses the Petty Cash Fund.
Complete and sign the form. In the address field, include the department or agency number.
Note: No stamped or electronic signatures will be accepted. A handwritten signature is required.
Questions about this form or process? Email [email protected].
To avoid processing delays do not leave any field blank. It is important to include the department or agency number in the address.
First Name: __________________________ M.I.: ___ Last Name: _______________________
Supplier ID: DENVR _____ _____ _____ _____ _____ _____ _____ _____ _____ _____
Department or Agency: __________________________________________________________
Address: ________________________________ City: _______ State: ___ Zip Code: ________
A Petty Cash Fund in the amount of $ ___________________, is retained at the above listed location.
Pet
ty C
ash
Fu
nd
By signing below, I certify the information provided above on this form is true, accurate, and complete.
Petty Cash Fund Custodian Signature: _________________________________ Date: __________
Ret
urn
Return the form by email to [email protected]. Questions? Email [email protected].
