Beruflich Dokumente
Kultur Dokumente
Agency: Station:
DEMAND, is hereby made that you produce all your cash, checks,
money orders, cash items, paid vouchers, and/or unused accountable
forms, etc., for which you are officially accountable as ______________
of the _____________ and any fund, checks, and/or cash items in your
possession held by you for deposit and safekeeping.
NOTED AND
Accountable Officer's Auditor/Examiner's
COMPLIED Date:
Signature: Signature:
WITH
B. CASH COUNT
No. of
Denomination Amount Presented Allowed Disallowed
Pes.
Total, As Presented Total
Inc.
Name of Incl usive Name of
Qty. Denomination Amount Qty. Serial
Form Serial No. Form
No.
Total
CERTIFICATION
Cash and/or cash items ... ....... . ... ... ...... ... ... ... ... .. __________
Unused accountable forms with money value ..... ...... __________
Unused accountable forms without money value . ..... __________
Accountable Officer's
Position/Designa tion: Agency/Station:
Signature: