Fund Custodian: Date: 6/24/2019 7:07

Total Authorized Amt: PHP 0.00 Reviewer:

Bills Coins
Value Quantity Amount Value Quantity Amount
PHP 1,000.00 PHP 0.00 PHP 10.00 PHP 0.00
PHP 500.00 PHP 0.00 PHP 5.00 PHP 0.00
PHP 200.00 PHP 0.00 PHP 1.00 PHP 0.00
PHP 100.00 PHP 0.00 PHP 0.25 PHP 0.00
PHP 50.00 PHP 0.00 PHP 0.10 PHP 0.00
PHP 20.00 PHP 0.00 PHP 0.05 PHP 0.00

Total Bills PHP 0.00 Total Coins PHP 0.00

1. Total Cash (bills and coins) PHP 0.00

2. Total Send Out (list attached including date, payee, amount) PHP 0.00

3. Total Pay Out (list attached including date, payee, amount) PHP 0.00

4. Less Total Authorized Amount PHP 0.00

5. Variance Over (Short) PHP 0.00

Petty Cash in the amount of PHP 0.00 was returned to me intact after being counted by
the reviewer noted below:

Fund Custodian:
Name & Signature Date

Cash Counted by:

Name & Signature Date

Noted by:
Name & Signature Date