PRENUMBERED RECEIPT - UNIVERSITY PARK

Form Instructions

1. Indicate the name of the individual making payment and the date money is received.
2. Describe the item/service for which payment is received.
3. Indicate the department number receiving credit and the amount received.
4. Mark if cash or check was received and the check number.
5. Indicate department name receiving the money.
6. Sign the form as the University representative receiving the money.