Cash Count
Department
Type
of Fund
Date
of Count: Counted by:
Time
of Count: Custodian:
Total Cash and Cash Items Counted
Quantities
Total
Currency Bundles Loose Nr. Bills Extension Totals
Hundreds (10 ea) $
Fifties (20
ea) $
Twenties (25 ea) $
Tens (25
ea) $
Fives (20
ea) $
Ones (25
ea) $ $
Quantities
Total
Coin Bundles Loose Nr. Coins Extension Totals
Halves (10 ea) $
Quarters
(40 ea) $
Dimes
(50 ea) $
Nickels (40 ea) $
Pennies (50 ea) $ $
Checks (attach tape or listing if
applicable-WP )
Petty cash vouchers (attach tape or
listing if applicable-WP )
Other cash items (list separately and
describe adequately-WP )
Total Cash Counted $
Total Accountability for Above Cash
Receipts Type
Description Beginning Nr.
Ending Nr. Date Amount Totals
$
$
$
Petty Cash Fund per General Ledger
Account:
Change Fund per General Ledger
Account:
Other (list separately and describe
adequately-WP )
Cash over <short*> (attach
explanation if significant-WP )
Total Accountability (Per Above Count) $
Receipts For Funds
The above cash and cash items of $ were
counted in my presence and returned to me intact on
the above indicated date by the NCEL
Auditor.
(Signature)
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