Income Remittance Form

FINDLEY OAKS PTA

INCOME REMITTANCE FORM

This form must accompany all monies given to the Treasurer of the Findley Oaks PTA.

DATE:            ____________________________________________________________

ACTIVITY:            ____________________________________________________________

BUDGET LINE ITEM/COMMITTEE:            ____________________________________

A. Currency Received:                                                         B. Checks Received 

                                                                                                (bundle in stacks of 50 checks)

______ pennies  x       $.01= $ __________                            How many ?  __________

______ nickels   x       $.05= $ __________                

______ dimes     x       $.10= $ __________                                 Sort checks by denomination

______ quarters  x       $.25= $ __________                            and note below:

______ ones       x      $1.00= $ __________                           

______ fives       x      $5.00= $ __________

______ tens        x    $10.00= $ __________

______ twenties  x    $20.00= $ __________

______ fifties      x    $50.00= $ __________               

______ hundreds x  $100.00= $ __________

                   Total Currency:  $ __________

Total amount of checks: $            $ __________

Grand Total funds received: $ __________ (total from columns A and B)

The undersigned certifies that the funds shown above were received for PTA activities, properly accounted for and are to be credited to the appropriate PTA account as noted.

Signature1: ________________________________      Date: _________________

Signature2:________________________________    Date:__________________

Your Email Address:            __________________________________________________________

Your Phone Number:            _____________________________________________________

If a small amount of money is being remitted, please put in the Treasurer’s mailbox by the clinic.  If a large amount of checks or cash is being remitted, please contact Amy Lockerbie (770-475-9817) to make arrangements or leave it with Jill Ruffin at the front office.  If you leave the money at the front office, please call Amy to let her know it is there.

Remit money collected as soon as possible.  Please do not use staples.