Municipality: __________________ DV No.

______________ Date: _________________ Amount: ____________

Barangay: ____________________ Check No. ___________ Date: _________________

Establishment of Petty Cash Fund

Documents Items to check Y/N Remarks
1. Disburseme  Is it chronologically numbered?
nt Voucher  Is the date on or after the Minutes of
ExeCom meeting?
 Is the payee the BDC-TWG
Treasurer?
 Is the total amount equal to the
approved amount for PCF by the
ExeCom?
 Is the account title correct?
 Is it signed:
Prepared by the Treasurer?
Approved by the BDC-TWG Chairperson?
Reviewed by Municipal Financial Analyst?
Received by Payee?
 Is the Certified photocopy of check
attached?
2. Minutes of
Execom Meeting and
 Does it approve the establishment
attendance Sheet
of PCF?
 Is the amount approved not more
than 10,000?
 Is it signed by
Prepared by Brgy Secretary?
Approved by the BDC-TWG Chairperson?
 Are the committees well
represented?

Replenishment of Petty Cash Fund

Documents Items to check Y/N Remarks
1. Disburseme  Is it chronologically numbered?
nt Voucher  Is the date on or after the last PCV?
 Is the payee the BDC-TWG
Treasurer?
 Is the total amount equal to the
actual petty cash spent or the total PCVs?
 Is the account title correct?
 Is it signed:
Prepared by the Treasurer?
Approved by the BDC-TWG Chairperson?
Reviewed by Municipal Financial Analyst?
Received by Payee?
 Is the Certified photocopy of check
attached?

 Are all PCVs accounted for?

2. Petty Cash
Liquidation Summary  Is the amount indicated per PCV
correct based on the attached supporting
document?
 Is the summation correct?
 Is the total amount more than 75%
of the established PCF?
 Is it signed by the Treasurer?
 Is it reviewed by the AIC? (indicator:
initial before the BDC-TWG Chairperson)
 Is it approved by the BDC-TWG
Chairperson?

3. Petty Cash  Is it dated?

Vouchers with Supporting
Documents
 Is it chronologically numbered?
 Is it signed by
Requesting party?
Approved by the BDC-TWG Chairperson
or the PIT Head?
Received by Requesting Party?
Note:
1. All photocopied Documents shall be Certified True Copy by the Treasurer (signature over printed name and position).
2. After Payment, all documents shall be stamped PAID.