Cash Receipt Transmittal
This form is used when submitting coins, currency, checks, and/or money orders for deposit. Complete all sections of the
form. Please be sure to record the orgn and account the funds are to be credited to along with a brief description of the
deposit. A receipt will be issued by the cashier for you to compare to your records.
Business Office Use Only
Receipt # _____________________
Date _____/_____/_____ Date Received__________________
Received from ____________________________________________________________Department
Prepared by ________________________________________________________________________
For (Name of Event or Other Description. Give specific details.)
Account to be credited:
- Fill in Fund only if other than Fund 1000 and Program only if other than the Orgn default.
Fund Orgn Acct Prog Amount Desc
Cash Recap: Cash $__________________ Checks $__________________ Total
Please send cash and checks to the business office promptly
. DO NOT HOLD.
SUBMIT A COPY TO THE CASHIER; RETAIN A COPY FOR YOUR RECORDS