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r( $ S Cash Paid Out is to be used when the vendor or payee is known in advance, a receipt Department Name: Event: Event Date: Date Cash Needed: $ Amount: Denominations: Index:
Expense Code: Purpose of Cash Paid Out8 Print Name: ____________________________________________ ID#: _______________________ Date: ______________________9 Dept. Approval: _________________________________________$ Person Requesting the Cash Paid Out: Ext:^ Cash Paid Out can be picked up in Treasury during normal business hours 9:00 a.m. to 4:00 p.m.
Today's Date:Q (Paid out will initially be coded to 1904-Other Advances & moved when supporting documentation is received.)9 Responsible Party: ______________________________________f I authorize _____________________________________________ to pick up my paid out at Treasury Services.f I understand that I am responsible for the return of receipts and/or cash in full amount stated above.? This form cannot be used for a travel or entertainment advance. Event Location: Cash Paid Out Request FormA Fill out this form completely and send to your Fund Accountant. Z or supporting documentation will be available and processing a check is not appropriate. ; Request must be received at least 72 hours prior to pickup.. in accordance with MOMs policy #326 Section V.l If you do not provide the request 72 hours prior to pick up, you run the risk of the cash being unavailable = k Cash Advancep Please provide the accounting where the expense should be recorded when the back-up paperwork has been received.B (Other than the person picking up the cash)x Upon receipt of paid out, departments must provide Treasury with unexpended funds and receipts to their Fund Accountant a within 48 hours. The Fund Accountant will process the necessary paperwork to record the expense. * KI J K FM O c c F B ~-z4nA_)k:~yw
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