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f., ~ ,w_._.____-_..._....._.. <br /> ~r-~ <br /> rr" ~ <br /> ~ _ <br /> ~ Petty Cash Request <br /> Person requesting cash Print} ~'8 _ <br /> Supervisor's approval <br /> ~ ;4 <br /> . Request far Reimbursement <br /> (To request advance, use next box.) <br /> Date C~'~ Custodian's intials <br /> - <br /> 7: <br /> J <br /> u <br /> ~ ~1 ~ # ~ ~ Expenditures Empl yee gnat <br /> r <br /> 'S <br /> ,,i <br /> M <br /> EM <br /> BER <br /> 79~4~540~ <br /> R `tf rA v <br /> e ue~s a d once of Funds <br /> q . <br /> F <br /> AL <br /> $ ~ $UL$~ ~ . ~7 (To request"reimbursement, use previous box.) <br /> O34 FALL ULBS 9.97 <br /> 3 715$? ~ANAN , <br /> .Date Custodian s intial <br /> - s <br /> w.. <br /> 7i 5$7 BANAN ~ ~ - <br /> X431 l VqR, F~FIN • Amount Employees Enitials _ <br /> <br /> c <br /> TDT~L Expenditures Custodian s initials ~ <br /> • r~ <br /> VF Rm r , <br /> _ _ ~ _ ~ ~ ~ f:r ~ ExPres~ i 93 Money returned Employee s signature ~ <br /> ~ _w Amount due II <br /> X~~}~~~~~~~X ~ D~D ~ _ ~ _ ~ w to employee E~~ <br /> 5e~# ~ 000557 SWII~Ea - <br /> Red'#~ 5~~57~ ~ <br /> ~ C~~1 ExPre~S ,Vendor and Item Purchased <br /> FAD Y; Re~R ~ pA <br /> ~5~ ~ <br /> APPROVED <br /> AMO~lNT ~ ~~9.9~ 1. <br /> OU 17 04$ 440~~040~~ <br /> 075 <br /> f <br /> ,W ccount Codes <br /> -1: - - r <br /> CHANGE <br /> ~OO <br /> TOTAL NUMBER OF ITEM - - - - - - - _ <br /> C S SOLO ~ 5 - ~ ~ x ~ <br /> AswIER~ GLRIR G. <br /> ~ V I ~V ~ I V~ 1/ r~5 gO Re~is~d TAL: $ 9'~ <br /> ~1~~~~ ~a~~ ~~~i~~ <br /> ' <br /> ~ <br /> ~I Petty Cash J4eques~ t <br /> 6 <br /> • int <br /> Person requesting cash ~Pr ~ <br /> Supervisor's approval <br /> ~4 <br /> . Request for Reimbursement 4 ' <br /> (1"o requ t advance, use next box.j <br /> Date Custodian's intials _ <br /> Expenditures Emp# e's signat re <br /> ~ ,.r <br /> Req~1'est for Advance of nds <br /> i ~F-~ (1"a requestein7btlrsement. use previous box.) t <br /> . .k; <br /> " kw, Date Custodian's intials <br /> ~ ~ ~ µir ~ <br /> ~~~Y~ ~ ~~w~~ . i~~.~''~~ Amount ~ Employee's initials ~ <br /> •l~~ ' Expenditures Custodian's initials <br /> tip' r~„n 6'...;~ -.._._.__._....__m~...~__..__• <br /> • E ~ <br /> ' , ` r"~~ ~ Money returned _..~f ' Employee's signature ' <br /> ~ ~ ' Amount due " <br /> ;i <br /> ~ ~~~~~~1~ ~ to employee <br /> k Vendor and Item. Purchased <br /> ~ <br /> .i. :.d i ~ j <br /> A ount Cod~js ~ <br /> I <br /> - - - - - ~ j <br /> J <br /> <br />