Wesleyan University

Petty Cash Reimbursement Voucher

 

 

 

Department Name: ________________________

 

Custodian Name:  _________________________ Phone #/Ext.:  ___________

 

Date:  _______________

 

Cash Balance on Hand                                                        $____________

 

Total to be Reimbursed (total from below)                         $ ____________

 

Total Value of Petty Cash Fund                                           $____________

 

Please use the space below to summarize by account/object code the petty cash transactions.

 

 

Acct/Object Code

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total Amount to be Reimbursed

 

 

Transfer the above lines to the Accounts Payable Voucher Form.  Put all receipts/documentation in an envelope and staple to these forms.