UNIVERSITY OF VIRGINIA
FINANCIAL AND ADMINISTRATIVE PROCEDURES MANUAL
TITLE: PREPARATION OF PETTY CASH PROCEDURE: 4-2
REIMBURSEMENT VOUCHER
Policy Reference: IV.B.1
Form: Petty Cash Reimbursement Voucher
(Form DA-02-040, Comp. 7)
Obtain Blank Forms From: Accounts Payable, Carruthers Hall,
924-4365
Forward Completed Forms To: See page 4.2.4, Fiscal
Administrators. Completed forms
must be sent to Accounts Payable,
Carruthers Hall. This form is to be
accompanied by the completed Petty
Cash Voucher (A0-002).
See also Procedure 4-1, "Preparation of Petty Cash Voucher."
Purpose
This form is used to obtain reimbursement of petty cash
expenditures chargeable to local, research or State Funds.
Background
Before all petty cash has been expended, the custodian should
submit a Petty Cash Reimbursement Voucher (DA-02-040, Comp. 7) to
Accounts Payable for reimbursement of the fund. Allow a minimum of
two weeks for reimbursement on State Funds. In general, a petty
cash fund adequate to the needs of the department should be
reimbursed at least once a month.
Instructions
Note: See page 4.2.4 for copies required.
The numbered items on the sample form should be completed as
follows:
1. Indicate department name.
2. Period of time covered by voucher.
3. Indicate the initials and last name, followed by the word
"custodian" and the complete mailing address of the
custodian. For example: "T. Jefferson, Custodian"
4. Balance per last Report. Dollar amount shown in item 8
on last report.
RECONCILIATION OF ACCOUNT
5. Reimbursement last Report Dollar amount shown in item 7 on
last report.
6. Total Add items 4 and 5 together.
7. Amount claimed on this Total appearing in "Amount
voucher Certified for Payment"
(item 10).
8. Balance in Bank or on Hand Subtract item 7 from item 6 and
enter difference here.
9. Description of articles or services and amount. All
expenditures recorded herein must be substantiated by
attached Petty Cash Vouchers (A0-002) and receipts. This
SHOULD be a summary of all like object codes within the same
University Account Code. Enter the complete eleven-digit
University Account Code(s) and the respective amount(s).
10. Indicate the grand total of all expenditures.
11. LEAVE BLANK. THIS CERTIFICATION SPACE IS RESERVED FOR USE BY
ACCOUNTS PAYABLE. DO NOT WRITE IN THIS AREA.
ISSUED BY: 04/05/94
Accounts Payable 4.2.2