Cash Verification Form Template 2018-19
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CASH VERIFICATION FORM - Meadow Heights PTA
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Committee, Event or ProgramDate
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Prepared by
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Print NameSignature
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COINSCHECKS
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x 1¢ =$0.00 Check NumberAmountCheck NumberAmount
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x 5¢ =$0.00 116
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x 10¢ =$0.00 217
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x 25¢ =$0.00 318
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x 50¢ =$0.00 419
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x $1 =$0.00 520
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SUBTOTAL COINS
$0.00 621
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722
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CURRENCY
823
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x $ 1 =$0.00 924
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x $ 2 =$0.00 1025
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x $ 5 =$0.00 1126
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x $10 =$0.00 1227
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x $20 =$0.00 1328
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x $50 =$0.00 1429
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x $100 =$0.00 1530
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SUBTOTAL CURRENCY
$0.00
TOTAL NUMBER OF CHECKS
0
SUBTOTAL CHECKS
$0.00
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DEPOSIT TOTAL
$0.00
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VERIFICATION SIGNATURE
Deposit Allocation to Budget Line Items
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All deposits must be verified by a second PTA member, who
If your deposit includes monies for multiple activities and/or events,
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cannot be a family member of the one submitting this form.
please declare here how the funds should be allocated:
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Amount Received $ ____________Date: _________________
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Printed Name:____________________________________
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Signature: ___________________________________________
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DEPOSIT ALLOCATION TOTAL
$0.00
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This total should equal DEPOSIT TOTAL above
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