Fillable Printable Sample Itemized Receipt Form
Fillable Printable Sample Itemized Receipt Form
![Sample Itemized Receipt Form](/resources/formfile/images/yum/receipt-format-0467214.png)
Sample Itemized Receipt Form
![](/resources/formfile/htmls/10003/receipt-format-04/bg1.png)
Itemized Receipt Form
(To be used when giving funds to Treasurer)
Event Date
Chairman Phone No.
Person completing form Phone No.
(Please make sure that there are always 2 people counting money to protect the reliability of the count)
Total of checks (attach a tape/written account) $
Bills # Amount
$100
$50
$20
$10
$5
$2
$1
Total
Total Bills $
Coins # Amount
Dollar
50 Cent
Quarters
Dimes
Nickels
Pennies
Total
Total Coins $
Total Cash $
Total Deposit $
![](/resources/formfile/htmls/10003/receipt-format-04/bg2.png)
Counter’s Signature
Counter’s Signature
Date
Received by Treasurer Date
(When turning in a deposit, please allow time for another count of the total deposit so a receipt can be given to the
person turning in the deposit)