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- PTA DEPOSIT RECEIPT FORM TEMPLATE
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PTA
Van Wyck Junior High School
6 Hillside Lake Drive, Wappingers Falls, NY 12590
DEPOSIT RECEIPT FORM
Date: __________________ Description/Budget Category: ______________________________
Contact: _________________________________________ Phone: _______________________
CASH COUNT
Number of Bills
__________ x $100.00 = _____________
__________ x $50.00 = _____________
__________ x $20.00 =______________
__________ x $10.00 =______________
__________ x $5.00 = ______________
__________ x $1.00 = ______________
TOTAL BILLS: = ______________
Number of Coins
__________ x $1.00 = _______________
__________ x $0.50 = _______________
__________ x $0.25 = _______________
__________ x $0.10 = _______________
__________ x $0.05 = _______________
__________ x $0.01 = _______________
TOTAL COINS: = _______________
NUMBER OF CHECKS: _____________
(Attach spreadsheet if more than 5 checks include check # and amount)
TOTAL CASH (BILLS + COIN): $ _____________
TOTAL CHECKS: $ _____________
TOTAL AMOUNT RECEIVED FOR DEPOSIT: $ _____________
VERIFIED BY:
SIGNATURE AND PRINTED NAME
SIGNATURE AND PRINTED NAME
