Petty Cash Receipt Form
Received From: UNIVERSITY OF WEST GEORGIA CASHIER
For the Following: Date: _______________
Vendor Name
Description of Items Purchased
Amount
Account Name: _______________________________ ________________________________________
Signature of Purchaser
Account Number: _________________________________ _____________________________________________
Departmental Approver
Approved: _______________________________________ _____________________________________________
Office of Controller/ Business & Finance Printed Approver Name
*Attach Original Paid Receipts to back of Voucher _____________________________________________
Revised 10/22/2010 Cash Recipient (to be signed at cashier’s window)
Total:
10.00
10.00