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CASH REQUEST FORM

Date: . / .. /

Payee: .. Department: .....


Amount Requested: P..

Cost Centre:

Department Head: .

Signature:

1. Cash Disbursement- Accounts Department


CASH
ISSUED

PURPOSE

CASH
TOTAL
RETURNED EXPENDITURE

P P P

2. Authorisation
POSITION

NAME

SIGNATURE

DATE

Resident Manager
Operations Manager
Compliance Manager
Finance Manager
A new cash request form must be completed on each occasion that cash is requested. Receipts and
any unused cash must be returned, and the remainder part of the form completed. Full details of
the expenditure as per receipts and/or invoices against disbursed cash request form should then be
recorded in the Petty Cash Book or List of Transactions.

Payees Signature:

Date: ..

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