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Petty Cash Voucher
BUSINESS UNIT:
choose one
BKCMP-CSUB Campus
BKASI-CSUB Associated Students
BKFDN-CSUB Foundation
BKSTU-CSUB Student Union
BKFFR-CSUB Foundation for Research
BKSPA-CSUB Grants
PC #:
DATE:
DEPARTMENT
NAME:
PURCHASED FROM:
Fund:
Department:
Account:
Program:
Project:
Class:
QUANTITY
ITEM
UNIT PRICE
AMOUNT
1
Reason for purchase:
2
Reason for purchase:
3
Reason for purchase:
4
Reason for purchase:
REQUESTOR
PRINT NAME HERE:
EMPLOYEE SIGNATURE:
__________________________________
I hereby certify that the above goods and/or services were received by and necessary for use of the State of California and that quantity and quality are as indicated.
SUB TOTAL
AUTHORIZER
PRINT NAME HERE:
APPROVED
SIGNATURE:
__________________________________
SALES TAX
PAID BY REVOLVING FUND
CHECK #:
RECEIPT OF THE TOTAL AMOUNT SHOWN HEREIN IS HEREBY ACKNOWLEDGED
TOTAL
NOTE: Make sure values on form are correct as
VALUES ARE CLEARED BEFORE PRINTING AND FORM IS REFRESHED!