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, a <br /> f; <br /> 5.. <br /> t <br /> Petty Cash Reques <br /> ~ ~ ~L~ ~ ~ 5 <br /> i~.~ <br /> Person requesting cash ~Prmt} <br /> Supervisor's approval <br /> imbursement <br /> r Re <br /> st fo <br /> Re ue <br /> q <br /> {To request advance, use next box. j ~ <br /> ~ ~ ~ ~ , ~ ~ ~ f~ ~ ~ ~ ' n's intials <br /> ~ ~ Date ~ d~~. Custadia <br /> Y e' si afore <br /> Expenditures ~ Employ <br /> i. <br /> Request for Advance of Funds ~ <br /> ~ ~ ~ _ {To request reimbursement, use previous box.) <br /> ~T - <br /> TEL <br /> T~ n s intials <br /> t is <br /> Cus od <br /> Date <br /> :t Em la ee's initials <br /> C~~~ ~ jj t I, ~:;~1 ~ ~ ~ Amount p Y 1 ~,I <br /> 4l` ~ { ~ ~ 1 <br /> <br /> ' ~ ~ ~ Expenditures Custodian s in~t~als <br /> Em to ee's signature <br /> ned p Y <br /> retur <br /> ane <br /> M <br /> Y <br /> ~ ~ ~~1~~~ Amount due <br /> ~ <br /> T~l~~~ ~ ~ <br /> ee <br /> to employ <br /> (~~\j1 T <br /> w ~~i~~M ~ ~ ~ ~ ~ ~ ~ T i~. - <br /> ,1 <br /> ~rA ~ Vendor and item Purchased <br /> t <br /> 5 <br /> ~ `g`'~yf {/)yAc/~jcount(~'{fCodes <br /> S~ <br /> i <br /> j f:. <br /> . J,.f <br /> J.f <br /> • t r... - r..... - ~ <br /> ww~~a oss~ TOTAL: <br /> F <br /> ~ ; <br /> a II <br /> s'. <br /> Petty Cash- Request <br /> t <br /> ~ a~~= ~ ~ t~~~ stirs cash Print L ' <br /> Person re ue } <br /> ~ ~ <br /> - 5upervisor's approval ! <br /> I <br /> ~ Reques or Reimbursement <br /> ' ~ <br /> ' ~ - {7o request advance, use next box.) <br /> Date ~r ~ <br /> ~ ~ ~ Custodian's intials <br /> Expenditures Employee's 'nature <br /> Re oast for Advance of Funds <br /> ~ {To request reimbursement, use previous box,) <br /> J"a t J ~ <br /> ' ~c„h~ ~ ! , ~ ~ ~ Date Y 111~~f CustodEan s intials <br /> 1Jy '~f'~yf ~5 ti .~s CJ S F ~ fit:. ~ <br /> l~~ i.,~~~ %LfY`7IS J~~~~n~ l i ~ f Amount ~ ~ Employee's initials ~ g <br /> ~ ~ ~ ~ ~ ~ Expenditures ~ ~ Custodian's initials <br /> Money returned _ _ Employee's signature <br /> Amount due <br /> r ' to employee ~ _ ~ <br /> Vendor and Item Purchased <br /> . <br /> n <br /> ~E~ ~~F t~C~w 1~~~i»Ft~i~~~~ J ~1: Account Codes <br /> i <br /> <br />