Sample Petty Cash Worksheet
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Petty Cash Count Worksheet      
       
Bills:   Coins:  
       
$ 1   .01  
       
$ 2   .05  
       
$ 5   .10  
       
$ 10 ..   .25  
       
$ 20 ..   .50  
       
$ 50 ..      
       
$ 100 ..      
       
Total Bills   Total Coins  
       
Total Cash Per Count  
   
Fund Shortage  
   
Fund Overage  
   
Date:______________________________  
   
Counted By:________________________  
   
Witnessed By:______________________  
   
Comments:  
   
   
   
Ma and Pa's Actual Count
Petty Cash Count Worksheet      
       
Bills:   Coins:  
       
$ 1 1.00 .01 0.10
       
$ 2   .05 0.20
       
$ 5   .10 0.20
       
$ 10 ..   .25 0.50
       
$ 20 ..   .50  
       
$ 50 ..      
       
$ 100 ..      
       
Total Bills 1.00 Total Coins 1.00
       
Total Cash Per Count 2.00
   
Fund Shortage 2.00
   
Fund Overage  
   
Date Feb 27,xxxx  
   
Counted By: Ma  
   
Witnessed By: Pa  
   
Comments:  
   
   
   
Petty Cash Replenishment  
Check Approval Form  
   
Amount: 128.00  
   
Payable To: Petty Cash- Ma  
   
Date Approved: Feb 27, xxxx  
   
Documentation Reviewed, Verified  
and Approved By: Ma  
   
Check Number: 250  
   
Date Check Issued: Feb 27,xxxx  
   
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