
 
PETTY CASH RECEIPT 
 
NO.    __________________________ 
DATE __________________________ 
 
PAY TO: _____________________________________________________________________$__________________________________ 
 
BUSINESS PURPOSE/DESCRIPTION: __________________________________________________________________________ 
 
__________________________________________________________________________________________________________________ 
 
FAS ACCOUNT (10 DIGIT)  AMOUNT      AUTHORIZED BY             DATE 
_____________________  _____________________  _____________________        ________ 
_____________________  _____________________  RECIPIENT SIGNATURE             DATE   
_____________________  _____________________            _____________________        ________ 
_____________________  _____________________ 
    TOTAL    _____________________     
.................................................................................................................................................................................................................................... 
 
 
 
PETTY CASH RECEIPT 
 
NO.    __________________________ 
DATE __________________________ 
 
PAY TO: _____________________________________________________________________$__________________________________ 
 
BUSINESS PURPOSE/DESCRIPTION: __________________________________________________________________________ 
 
__________________________________________________________________________________________________________________ 
 
FAS ACCOUNT (10 DIGIT)  AMOUNT      AUTHORIZED BY             DATE 
_____________________  _____________________  _____________________        ________ 
_____________________  _____________________  RECIPIENT SIGNATURE             DATE   
_____________________  _____________________            _____________________        ________ 
_____________________  _____________________ 
    TOTAL    _____________________