UNIVERSITY OF PITTSBURGH FORM INSTRUCTION GUIDE 

FORM NUMBER:      FORM 0046

FORM TITLE:            Petty Cash Voucher

PROCEDURE:           05-06-06

EFFECTIVE DATE:    April 1, 2005

PAGE (S):                   1

PLEASE PRINT LEGIBLY IN INK OR TYPE.

Refer to University Policy 05-06-06 for detailed instructions.

 

1.   Name of Petty Cash Fund Enter the name of the Petty Cash Fund.

2.   SITE ID Enter the SITE ID.

3.   Date Enter the current date.

4.   Department Enter the department name.

5.   Purchased From Enter the vendor name(s).

6.   Account Number Enter the appropriate 32-digit account number(s) to be charged for

      purchases.

7.   Description of Expenses Enter a brief description of the item(s) purchased.  This

      form is restricted to emergency expenditures.  All purchases must be in accordance

      with University Petty Cash Policy 05-06-06.

8.   Amount Enter the amount of each purchase.

9.   Total Enter the total of the amount(s) entered in the Amount column.

10. Name of Petty Cash Custodian Enter the name of the Petty Cash Custodian.

11. Name of Recipient Enter the name of the recipient.

12. Signature of Recipient Obtain the signature of the recipient and include the check

      number if the recipient was reimbursed by check.

13. Date Enter the date the reimbursement is received (must be completed by the

      recipient).

14. Name of the Department Administrator Enter the name of the person authorized to

      approve purchases made to the account(s).

15. Signature of Department Administrator Obtain the signature of the person

      authorized to approve purchases made to the account(s).

16. Phone Number Enter the campus phone number of the Department Administrator.

      (The Administrator may be called to verify his/her authorization of the purchase.)

17. Date Enter the date the Department Administrator signed the Petty Cash Voucher.

Staple the original receipts(s) to the back of the form.  Copies will not be accepted.