Petty Cash Record and Reconciliation

  Prepared by:                            Department:                                      

  
                                                      Cash Received
    Date         Paid To or Received From     For     Cash DisbursedBalance

















































                                                          Summary
 P.C. Reimbursement: Date:                        Amount:                                  
                                                Cash on hand:                                        
 By:                                                      Check #:
                                                Petty cash slips:                                      
                                                 
                                                Total:                                                   
 Reconciled By
                                                þ Over         þ Short                
           
                                                Disposition:   Disposition:           
 Supervisor Approval