PETTY CASH RECONCILIATION

FOR THE MONTH ENDING

Account Number

Custodian Name(s): email/phone #

email/phone #

Account Purpose

Frequency of Reconciliations

Account Authorized Dollar Amount

General Ledger Balance (D)

Cash on Hand:

Cash

Coin

Total Cash on Hand 0 (A)

Receipts on Hand:

Date Purpose Vendor/Payee Amount

Total Receipts on Hand 0 (B)

Other (including Petty Cash reimbursements pending from DFA):

Total Other 0 (C)

Total Petty Cash Balance [(The sum of (A)+(B)+(C)] 0 (D)

Variance (Take GL balance (D) and subtract it from

The Total Petty Cash Balance (D)) Amount should be zero 0

Explanation of any variance to General Ledger Balance:

Reconciliation Completed by : Date:

Reconciliation Reviewed by: Date: