PETTY CASH RECEIPT DECLARATION

Date:

In accordance with the Petty Cash Policy

established by Madi Bin Askar Al Hajri Sons Co, I

____________________

hereby

confirmed

that

_______________________________

_as

petty

I,
cash

___________ custodian in ___________________________ received

__________/

the

amount

_________________________

SR ) to be used for incidental purchase

where normal purchasing methods are not

applicable and to ensure that the petty cash funds

are

managed

and

controlled

effectively,

efficiently, economically, and transparent with the

___ rules and regulation of the company. I shall also

75 . liquidate and replenish in a period of ___ days or
*

..

at exceptional case of 75 % usage of the Petty

Cash amount.
In the event where procedures and guidelines
of this policy have been violated, I will be
subjected to sanctions that are provided by the

I agree to accept the responsibility of petty cash fund accord

Ing to the policy and procedure.
.
Custodian Signature: ____________________
______________________ :

Date: _______________________

_______________________ :

Approval /
Departmental Head Signature

Accounts Manager Signature

COO Signatures