Petty Cash Fund-Responsibility Statement

Revised:  September 12, 2003  

I accept full responsibility for the Petty Cash Fund described below, which was established for and received by me.  I certify that I have read and understand the responsibilities and restrictions outlined in the Agency's Administrative Procedures and the TAMUS Policy on Petty Cash Funds.  I understand that I will be held responsible for the proper safeguarding and disbursement of these funds and will be required to reimburse the fund for any loss due to negligence on my part or due to improper disbursement of funds.


Petty Cash Fund Amount:       

Vendor Identification No:      

Date Issued:                       


Signature of Custodian:                                                                Date:                                   

Signature of Witness:                                                                   Date:                                   


Completed form must be returned to the Budgets & Accounting Department.

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