FUND

DEPOSIT FORM

DATE OF SUBMISSION: _______________________

DATE OF EVENT:_____________________________
NAME OF PERSON DEPOSITING FUNDS:
COMMITTEE/PROJECT:
FUNCTION GENERATING FUNDS:
DEPOSIT:

AMOUNT:
TOTAL CASH

$___________________

TOTAL COIN

$___________________

TOTAL CHECKS

$___________________

TOTAL AMOUNT DEPOSITED

$________________

Instructions:
1.
2.
3.
4.

This completed form must accompany all deposits.

All funds must be deposited within ten (10) days of the event.
Please roll all loose coin for deposit (if applicable).
Checks may be placed in the Treasurers Mailbox. Please arrange to deliver any Cash to Treasurer in
person.

For Treasurers Use Only

Date Funds Received:____________________________________________________________
Received From:_________________________________________________________________
Amount of Deposit:______________________________________________________________
Account:______________________________________________________________________
Date of Bank Deposit:___________________________________________________________

Revised 05/12