Cash Advance Form

To be used to advance funds to an employee/department from a finance and accounting

department in order to make an authorized purchase.

Date of Advance : ______________________

Advance amount : $ _____________________

Person receiving advance/Title : ____________________________________________________________

Department : ____________________________________________________________

Budget Code (accounting) : ____________________________________________________________

Item(s) to be purchased : ____________________________________________________________

Purposes : ____________________________________________________________

______________________________________________________________________________________________________

Remarks : ____________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

Supervisor/Manager approval : _________________________ __________________________

Signature Name

Advanced by : _________________________ __________________________

Signature Name

Received by : _________________________ __________________________

Signature Name