MISSING RECEIPT FORM
Cardholder/Employee/Approving Official must fill out
form below:
Date of Purchase/
Service
Vendor Name
Description of
Purchase
_______________________
_________________________________________________
________________________________________________
_________________________________________________
G/L Account Code:
_______________________
_______________________
Dollar Amount
Reason you were unable
to obtain receipt/invoice_________________________________________________
Date______________
Cardholder/Employee Signature__________________________
Department Head Signature_____________________________
City Manager Signature_________________________________
City of Hendersonville
Form of payment (exp. P-card, cash, check, credit card) _______________________
____________________________________________________________________
ALL FIELDS MUST BE FILLED OUT
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signature
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signature
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signature
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