PETTY CASH REPLENISHMENT REPORT (PCRR)

INSTRUCTIONS
A. This report shall be accomplished as follows:
1. Agency – name of the agency
2. Period Covered - period covered by the report
3. Report No. - assigned report number which shall be as follows:

000-00-00-000
Serial number (one series for each year)
Month
Year
Petty Cash Custodian Code
4. Sheet No. – page number
5. Date – date of the Petty Cash Voucher (PCV)
6. Petty Cash Voucher No. – the serial number of the PCV to be
presented in numerical order
7. Particulars – nature of disbursements/expenses as shown in the
PCV
8. Amount – amount paid covered by the voucher
9. Certification - name and signature of the designated Petty
Cash Custodian (PCC) and date of signing
B. This report shall be used for replenishment of the Petty Cash Fund.
All liquidated PCVs shall be attached together with all the
supporting documents.
C. The PCC shall prepare this report in two copies distributed as
follows:
Original – Accounting Unit as attachment to the Disbursement/
Replenishment Voucher together with the original of
the PCVs and supporting documents
Duplicate Copy – PCC File

D. At the end of the year, the PCC shall submit all paid PCV for
replenishment to record expenses incurred.
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AO 6/15/02

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