UNIVERSITY OF PITTSBURGH / FORM INSTRUCTION GUIDE
FORM TITLE: CASH REPORT
NUMBER: FORM 0012
PROCEDURE: 05-06-02
Complete a Cash Report - FORM 0012 by entering the following
information where indicated:
ENTRY DATA
1. Responsibility Center Code: Refer to DED Table 18205
2. Departmental Name: Limit to 30 characters; Refer to
SPI 6, or DED Table 18321
3. Room number and Building abbreviation: Refer to SPI 9
4. Area code and telephone number
5. Report number: Department control number
6. Dates to/from: MM/DD/YY
DESCRIPTION OF DEPOSIT
7. Account number: Ledger-Unit Code-Subcode (L-UUUUU-SSS)
8. Entry code: 31, unless other entry code is more
appropriate, e.g.:
30, Student tuition and fees
32, Accounts receivable payments
33, Sponsored programs
34, Investment income
35, Gifts
36, State appropriation
37, Bank transfers
38, Investment proceeds
39, Loan proceeds
9. Description of deposit: Limited to 20 characters;
attach additional information to back of form
10. Amount: Dollar amount to be credited to specified
account
CERTIFICATION BY ORIGINATOR
11. Cash: Amount of currency and coins
12. Checks & money orders: Amount of checks and money
orders
13. Total: Sum of currency, coins, checks, and money
orders
14. Certified correct by: Signature of report preparer
15. Title: Working title of preparer
16. Date: Date of the report, MM/DD/YY
VERIFICATION OF RECEIPT
17. Received from: Signature of department representative
18. Date: Date received, MM/DD/YY
19. Time: Time received, HH:MM am/pm
20. Cashier's signature: Signature of receiving cashier
21. Cashier's stamp: Validation of receipt on white and
pink copies
VERIFICATION OF DEPOSIT
22. Amount deposited: Total amount from bank deposit
receipt
23. Date of Deposit: Actual date of deposit, MM/DD/YY
24. Bank Account Identification Code: 3-character code of
bank account to which deposit was made
25. Deposit Prepared By: Signature of depositor
26. Cashier's Stamp: Validation of deposit on canary copy
DATA CONTROL - GENERAL ACCOUNTING
27. Voucher Number: Financial system identification number