UNIVERSITY OF PITTSBURGH FORM INSTRUCTION GUIDE

FORM TITLE: PETTY CASH VOUCHER
NUMBER:     FORM 0046
PROCEDURE:  05-06-06
DATE:       April 1, 2005


PLEASE PRINT LEGIBLY IN INK OR TYPE.
Refer to University Policy 05-06-06 for detailed instructions.


1.    Name of Petty Cash Fund – Enter the name of the Petty Cash Fund.

2.    SITE ID: – Enter the SITE ID.

3.    Date – Enter the current date.

4.    Department – Enter the department name.

5.    Purchased From – Enter the vendor name(s).

6.    Account Number – Enter the appropriate 32-digit account number(s) to be 
      charged for purchases.

7.    Description of Expenses – Enter a brief description of the item(s)
      purchased.  This form is restricted to emergency expenditures.  All 
      purchases must be in accordance with University Petty Cash Policy 05-06-
      06.

8.    Amount – Enter the amount of each purchase.

9.    Total – Enter the total of the amount(s) entered in the Amount column.

10.   Name of Petty Cash Custodian – Enter the name of the Petty Cash Custodian.

11.   Name of Recipient – Enter the name of the recipient.

12.   Signature of Recipient – Obtain the signature of the recipient and include 
      the check number if the recipient was reimbursed by check.

13.   Date – Enter the date the reimbursement is received (must be completed by 
      the recipient).

14.   Name of the Department Administrator – Enter the name of the person 
      authorized to approve purchases made to the account(s).

15.   Signature of Department Administrator – Obtain the signature of the person
      authorized to approve purchases made to the account(s).

16.   Phone Number – Enter the campus phone number of the Department
      Administrator.  (The Administrator may be called to verify his/her 
      authorization of the purchase.)

17.   Date – Enter the date the Department Administrator signed the Petty Cash 
      Voucher.

Staple the original receipts(s) to the back of the form.  Copies will not be accepted.