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,pleasecall487‐2159.
•Pleasewritethefund,org,accountand programnumbersonthefron
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