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Petty Cash Voucher
1) You may only be reimbursed if your department does not have a petty cash fund.
2) The original receipt(s) must accompany the voucher.
3) Maximum amount reimbursable is $100.
4) The person receiving the funds must sign this form and present photo ID.
5) You may not receive reimbursement for the following:
a) Personal Services (All 1XXX account numbers)
b) Travel (All 2XXX account numbers, except Mileage on 2006)
c) Contractual Services accounts 3005 – 3013
d) Food Items filed with a Rep Allowance form
e) Capital Expenditures (All 5XXX account numbers)
f) Student Aid (All 6XXX account numbers)
g) Entertainment Items (Account 8115)
See Accounting and Administrative Manual
Paid to: ___________________________________________________________________ Date: __________________
Department: __________________________________ Box # __________________ Phone # _________________
Description Fund Org Account Amount
Total Funds
Signature of Payee: _______________________________________________________ Date: __________________
Approving Signature: ____________________________________________________ Date: __________________

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