Petty Cash Voucher (Pcv) Template
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1PETTY CASH VOUCHER
(PCV)
INSTRUCTIONS
Box B - Paid by – shall be signed by
A.
10.
The form shall be accomplished as follows:
the PCFC
1. Entity Name – name of the agency/entity
Box B - Cash Received by – shall be
11.
–
2. Fund
Cluster
the
fund
cluster
signed by the recipient of cash
name/code in accordance with the UACS
3. No. – number assigned to the PCV by the
II. To be filled out upon liquidation
PCFC. It shall be numbered as follows:
Total Amount Granted – the amount
12.
0000- 0000-00-0000
of cash received by the claimant
Total Amount Paid Per OR/Invoice
13.
Serial number (one
No. _______ – the total amount paid
series for each year)
as shown in the OR/invoice presented
Amount Refunded/Reimbursed –
Month
14.
the difference between the total
Year
amount granted less amount spent
Box C – the PCFC shall check the
Petty Cash
15.
for
“Received
Custodian Code
appropriate
box
Refund” or “Reimbursement Paid”
Date – date of the preparation of PCV
and affix his/her signature
3.
Box D – the payee shall check the
–
16.
Payee/Office
and
Address
4.
for
“Liquidation
appropriate
box
name/office/address of payee/employee
Submitted” and/or “Reimbursement
requesting cash advance charged to the
Received
by”
and
affix
his/her
PCF
Responsibility Center Code – the cost/
signature
5.
responsibility center code of the requesting
B.
Part I shall be filled out upon request of
office
the petty cash advance and Part II shall be
filled out upon liquidation.
I. To be filled out upon request
C.
Particulars – brief description of the
The PCV shall be prepared in two copies
6.
distributed as follows:
nature of disbursement/expense
Amount – amount of petty cash requested
7.
–
Box A – Requested by – shall be signed
Original
to be attached to the RPPCV
8.
together with the supporting
by the Requestor
documents
Box A – Approved by - shall be signed by
9.
–
Copy 2
PCFC file
the Immediate Supervisor of the Requestor
128
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Parent category: Financial