CR# (Team Fill) _____________

West Bank Arts Quarter Team 2:

CASH RECEIPT FORM

PERSON TURNING IN CASH/CHECKS: ____________________________________________

DESCRIPTION: Please use the following 5Ws.

WHO:

WHAT:

WHERE:

WHEN:

WHY/HOW:

Fund DeptID Program Account PCBU Project Activity CF1 (10) CF2 (10) Fin EmplID C DOLLAR
(4) (5) (5) (6) (5) (8) (1) (7) S AMOUNT

TOTAL $
# OF CHECKS: CHECK #(s)—if applicable:
CASH

TOTAL AMT OF CASH & CHECKS

TAXABLE:  Yes  No

Tax Acct #: Tax Amt (team fill):

Signature of Dept Person: Date Rcvd (dept fill):

If this form is for

several checks,
run tape twice and
attach here.