CASH COUNT FORM

Name of Fund : Date :

Department : Time :

Currency Quantity Amount Total

Bills:
1000 10 10,000.00
500 -
200 -
100 5 500.00
50 -
20 -
Coins/Cents:
10 -
5 -
1 -
0.25 -
0.1 -
0.05 -
Totak Cash on Hand 10,500.00
Other Cash Items:
Checks for Deposits list attached -
For Cash Replenishment list attached 9,500.00 9,500.00
Advances list attached -
Reimbursements list attached -
Others list attached -

TOTAL 20,000.00
Initial Fund 20,000.00
Variance (Shortage/Overage) -

I hereby certify that the above ______________________ fund was counted in my presence by _________________________
of Finance Department and all cash, other cash items and forms are returned to me intact.
Also, I hereby acknowledged the overage/shortage of . - Any variance, shall be
deducted from my salary of the nearest payroll cut-off.

Counted by: Confirmed by:

Fund Counter/Date Custodian/Date

Note: Overages shall be monitored by PCF Custodian.

Noted by: If within one (1), no one claim the amount, this will be
deposited in the company's account.

Finance Manager/Date
 CASH COUNT FORM

___________________________________ ________________________
Department Date

___________________________________ ___________________ ________________________

Name of Fund Counted By Time

Currency Quantity Amount Total

Bills:
1000's _______________
500's _______________
200's _______________
100's _______________
50's _______________
20's _______________
Coins/Cents:
10's _______________
5's _______________
1's _______________
.25's _______________
.10's _______________
.05's _______________ _____________________

Other Cash Items:

Checks for Deposits list attached ____________________
For Cash Replenishment list attached ____________________
Advances list attached ____________________
Reimbursements list attached ____________________
Others list attached ____________________

________________________

TOTAL __________________

I hereby certify that the above ____________________ fund was counted in my presence by
_______________________ of Finance Department and all cash, other cash items and forms are
returned to me intact.
Also, I hereby acknowledged the overage/shortage of ___________________.

Signed:
_____________________________ _____________________________
Name of Custodian Date
 13,000.00
500.00
500.00
50.00
60.00
15.00
6.00
4.00
0.60
0.15
14,135.75
128,715.20
142,850.95
 80,000.00 10 1000 10,000.00 8 8000
2,500.00 1 500 500.00 3 1500
200.00 0 200 - 0 0
1,400.00 5 100 500.00 2 200
350.00 3 50 150.00 4 200
120.00 3 20 60.00 1 20
11.00 10 1 10.00 1 1
0.50 2 0.25 0.50
0.10 1 0.1 0.10
0.05 2 0.05 0.10
84,581.65 11,220.70 9,921.00
80,102.27 For Liquidation 68,779.94 10,078.33
35,354.00 For Liquidation
200,037.92 For Liquidation
Checks
For replenishment
80,000.64 19,999.33
62 62,000.00
1 500.00
1 200.00
7 700.00
-
2 40.00

63,440.00
9
1,208.00
27.00
35,354.00

100,038.00 200,037.97
Date 7/16/2019
Cash on Hand 74,860.55
Expenses for liquidation Ref #11 124,220.58
Expenses for liquidation Ms Joan 1,770.00
TOTAL 200,851.13
Purchasing Fund 200,000.00
Over/Short 851.13

Date 7/23/2019
Cash on Hand 23,225.25
Expenses for liquidation Ref #12 114,083.59
Checks 63,637.15
TOTAL 200,945.99
Purchasing Fund 200,000.00
Over/Short 945.99
To supplier 600.00
345.99

7/30/2019
Cash on Hand 84,581.65
Expenses for liquidation Ref #13 80,102.27
Checks 35,354.00
200,037.92
Purchasing Fund 200,000.00
Over/Short 37.92
SP SP EIB Onward GSSI End
7/18/2019 7/18/2019
52,126.38 8,466.80 135,453.73
(52,126.38) (8,466.80) 63,627.40
1,770.00
- - - - - 200,851.13
200,000.00
851.13

7/25/2019 7/25/2019 7/25/2019

33,567.45 43,417.79 1,743.75 - 101,954.24
(33,567.45) (43,417.79) (1,743.75) 35,354.60
63,637.15
- - - - - 200,945.99
200,000.00
945.99
600.00
345.99

84,581.65
80,102.27
35,354.00
- - - - - 200,037.92
200,000.00
37.92
 18,000.00 9,000.00
8,000.00 200.00
300.00 500.00
160.00
100.00 50.00
20.00 40.00
55.00 3.00 9,793.00
12.00 36,193.87
4.50 9,928.51
0.10 26,651.60 1,235.00 57,150.38
For Repl 56,517.45 (60,000.00) (2,849.62)
Checks 42,460.65
For Repl 8,934.87
For Repl 5,432.20
2,850.00
142,846.77
140,000.00
2,846.77 (2.85)
 5 1000 5000
16 500 8000
3 50 150

3 20 60
6 1 6
117,282.81
(44,822.60)
(30,000.00)
(42,460.65)

31,675.65
588.00
220.00
9,977.00
1.00 16.00 35.00 52.00 1,000.00 52,000.00
1.00 1.00 500.00 500.00
1.00 1.00 200.00 200.00
3.00 7.00 8.00 18.00 100.00 1,800.00
6.00 2.00 1.00 9.00 50.00 450.00
6.00 4.00 5.00 15.00 20.00 300.00
1.00 1.00 10.00 10.00
11.00 11.00 5.00 55.00
4.00 4.00 7.00 15.00 1.00 15.00
1.00 24.00 2.00 27.00 0.25 6.75
1.00 1.00 0.10 0.10
1.00 1.00 0.05 0.05
55,336.90
144,663.04
199,999.94
1,000.00 2.00 2.00 2,000.00
500.00 - -
200.00 - -
100.00 11.00 11.00 1,100.00
50.00 1.00 1.00 50.00
20.00 - -
10.00 1.00 1.00 10.00
5.00 10.00 10.00 50.00
1.00 19.00 19.00 19.00
0.25 18.00 18.00 4.50
0.10 5.00 5.00 0.50
0.05 2.00 2.00 0.10 3,234.10
For Liquidation
Checks 23,582.31
73,183.63
100,000.04
2,000.00 - -
- - -
- - -
1,100.00 - -
50.00 - -
- - -
10.00 - -
50.00 - -
19.00 - -
4.50 - -
0.50 - -
0.10 - -
3,234.10 - -
38,891.00
38,891.00

82,353.27
2,523.95
1,866.21
105,205.27
8,050.80