Westlane Secondary School Deposit Form

Please complete all yellow fields TO: FROM: Please Deposit to this account: Reason: Cheques: Name: Name: Name: Name: Name: Cont. on other side Total Cheques Enter the Bill Total below: Enter # of Bills 75 15 50 5 1 Total of Bills x x x x x $5 $10 $20 $50 $100 = = = = = Calculated $375 $150 $1,000 $250 $100 $1,875 Pennies Nickles Dimes Quarters Loonies Toonies Loose Change Total C.Washer C.L.View D.R. Tee $ $ Amount from other side: $ $ Enter the Loose Change Total below: How Many 25 50 80 300 500 250 = = = = = = = Calculated 0.25 $2.50 $8.00 $75.00 $500.00 $500.00 $1,085.75 Amount: $20.00 $35.00 $75.00 Secretary's Name 30-Apr-13

All loose change totalling or exceeding the # Pennies Nickels Dimes Quarters Loonies Toonies Total Rolled coin 2 1 3 1 2 3 rolls rolls rolls rolls rolls rolls = = = = = = $1.00 $2.00 $15.00 $10.00 $50.00 $150.00 $228.00
* All cheques must have some information written

following amounts should be rolled. 50 pennies 40 nickels 50 dimes 40 quarters 25 loonies 25 toonies one roll one roll one roll one roll one roll one roll = = = = = = $0.50 $2.00 $5.00 $10.00 $25.00 $50.00

Total Cash = Total Cheques =

$3,189

on them (on memo line, if there is one) to indicate to what accounts the cheques should be deposited.

TOTAL AMOUNT TO BE DEPOSITED =

$3,188.75

For Office Use Only: The amount of: Received by: Peter J. Campbell was deposited to your account on Date: