Fund Count & Custodian Transfer Form
IDAHO STATE UNIVERSITY
DEPARTMENT CASH COUNT
Fund No.
Fund Type: Change Petty Cash
Location:
Current Custodian:
Date Counted: Time Counted:
Number Amount
Currency:
$20 $
$10 $
$5
$
$1
$
Other
$
Total Currency $
Coins:
$1.00
$
$ .50
$
$ .25
$
$ .10
$
$ .05
$
$ .01
$
Total Coins $
Checks & Other Cash Items:
Date Check No. Drawn By
$
$
$
$
Total Checks & Other Cash Items $
Total Cash $
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FS-008
Revised Feb 2014
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Fund Count & Custodian Transfer Form
Total Cash (From Cash Count) $
Less Undeposited Receipts:
$
$
$
$
$
$
Total Undeposited Receipts $
Plus Unreimbursed Items:
$
$
$
$
$
$
Total Unreimbursed Items $
Fund Total $
Authorized Fund Total $
Cash Over / (Short) $
I hereby certify that the current custodian has counted the cash and cash items in my presence. The count total
represents all undeposited cash and cash items for which I will be responsible at the time of this count. The above cash
and cash items in the amount of $
have been transferred to me, the new fund custodian.
Current Custodian’s Signature Date
New Custodian’s Signature Date
Print Name
FS-008
Revised Feb 2014
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Forward a copy to Finance and Administration, Stop 8219