Department:_________________________
DetailCode:_________________________
(IfAssigned)
Fund Org Account Program Activity Loc ation Description Amount
AccountTotal $
Fund Org Account Program Activity Location
Shortage
PleaseincludetheFOPLforO/Sabove. Currency/Coin
Checks
CreditCards
MasterCard
Visa
DiscoverCard
AmericanExpress
CreditCardsTotal $
TENDERTOTAL $
CheckOne:
Instructions:
Completethisforminitsentirety.Forquestions,pleasecall4872159.
Pleasewritethefund,org,accountand programnumbersonthefron
t
ofallchecks.
Ifyouwouldlikeacopyofthisformwithacashier'ssignat ureforyourrecords,youwillneedtopresentcopies
totheCashier'sOfficewhendroppingoffthedeposit.
FOROFFICEUSEONLY:
EasternMichiganUniversity
DepositVoucher
Date:_____________________
Signature:___________________________
Address:____________________________
Preparer:_____________________________
Phone:_____________________________
Hold Receipt for Pick-up
Mail Receipts to Address Above
Received
Time__________ Initials_____________
Processed
Initials_______________
Notes
0.00
0.00
0.00