1. Vendor Number – Enter an 11-digit, alphanumeric number. This is the petty cash fund custodian’s Payroll Number, preceded by a “X” and followed by a zero. For example, X1234567890, with no spaces between numbers.
2. Department Ref. Number This is an optional field used by the department only. It does not print on the FAS AM091 Reports.
3. Page ___ of ____ – If more than one form is needed, enter the specific page number of the form in this section and the total number of pages which will be submitted with this request (e.g., page 1 of 5, 2 of 5, etc.).
4. Custodian Name and Address Enter the custodian’s name and faculty exchange address.
5. Description Enter a brief, but specific explanation of what the funds were used for. For business meals reimbursements, the names of the individuals in attendance, the purpose and place of the meeting must be clearly stated on either the Form 47R or the supporting documentation Note: Do not use “out-of-pocket expenses”.
6. Receipt Number Transcribe the receipt number(s) from the petty cash receipt(s)individual Petty Cash Receipt form(s) 47R.
7. Description Transcribe the description(s) from the individual Petty Cash Receipt form(s) 47R.
8. Account Number – Transcribe the 10-digit, FAS account number(s) from the individual Petty Cash Receipt form(s) 47R.
9. Amount – Transcribe the dollar amount(s) from the individual Petty Cash Receipt form(s) 47R.
10. Total Amount of Detail This Page Enter the sum of all Field 9 entries recorded. If there are multiple pages, enter the sum of all Field 9 entries recorded on that specific page.
11. Account Number – Enter the 10-digit FAS account number(s) and the sum of their dollar amounts that will be charged.
Note: The A FAS 10-digit account number can only be recorded once in this section, regardless of the number of pages or the number of receipts. Therefore, if an account number is used more than once, on any page:
- Identify the duplicated account numbers.
- Combine the dollar amounts associated with these account numbers.
- Then enter their combined sums into Field 12.
12. Amount Enter the dollar amounts associated with the account numbers in Field 11.
13. Total Reimbursement Requested – Enter the combined totals of all Field 12 entries recorded on each page. If there is only one page, enter the sum of all Field 12 entries recorded on that page. If there are multiple pages:
- Sum all Field 12 entries recorded on each page.
- Combine their totals.
- Then enter the combined totals in this field.
Note: Do not forget to include all Field 12 entries. In addition, note this amount should agree with the combined sum total of dollar amount(s) recorded on each page in Field 10, “Total Amount of Detail This Page”.
14. Total Cash on Hand Enter the amount of cash on hand.
15. Total Petty Cash Fund Enter the sum of Fields 13 and 14. Note: This amount must agree with the total amount of the “Fund” that was issued to the custodian
16. Requested By: Name, Phone, Department Name, and Date – Enter the name and department phone number of the Custodian. Enter the department name for which the petty cash fund has been established and the date of the request.
Note: The petty cash fund reimbursement will be held at the Bursar’s Office under the phone number recorded in this field. In addition, note that the payment will list the custodian’s home address instead of department address.
17. Authorized By and Date Enter the printed or typed signature of the authorized signer of the account(s) being charged and the date of the request.
18. Payroll Number and Authorized by Signature -If more than one form is needed, enter the specific page number of the form in this section and the total number of pages which will be submitted with this request (e.g., page 1 of 5, 2 of 5, etc.).