Fillable Printable Sample Itemized Receipt Form
Fillable Printable Sample Itemized Receipt Form
Sample Itemized Receipt Form
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 $
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)
