Select the date, from the calendar, the Receipt for Petty Cash Expended is completed
Enter the four digit Business Area Number
Enter the department name
Enter any internal department reference information such as fiscal year or any other relevant information
Table (a header row, five (5) columns, and five (5) rows for data entry)
Column 1 - Enter name of the vendor from whom the petty cash purchase was made
Column 2 - Enter a description of the item purchased using petty cash funds
Column 3 - Select the Cost Object Type from the drop-down list (if completing this form by hand, please indicate the type of Cost Object in space below the drop-down list on the form). Options include:
Cost Center
Internal Order
Work Breakdown Structure (WBSE)
Column 4 - Enter the Cost Object number to be charged
Column 5 - Enter the eight (8) digit General Ledger Account number to be charged
Column 6 - Enter the amount to be charged to this Cost Object number and General Ledger Account number
Total - This is a calculated field. No data entry is required
Enter the name of the employee receiving reimbursement
The employee must provide either a hand-written signature or provide their digital ID. If a hand-written signature provided, also include the date the form was signed.
Attach receipts within this area (use tape). If additional space is needed, attach receipt(s) by stapling to the back (one staple, upper left hand corner)
