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�r T01 <br /> WRIGHT MOTORS PETTY CASH REIMBURSEMEI 1T REQUEST <br /> i' For the period from to off. 3 Q / <br /> Custodian's Name (please print) �/z <br /> Phone: <br /> Itemized list of Petty Cash disbursements: Items will be charged to the account(s) listed. <br /> ACCOUNT NO./CODE/CATEGORY ITEMS PURCHASED AMOUNT M <br /> �/ lI /ire <br /> 37 / <br /> uito6j -(-Zto�w�d <br /> y 14fl �t �� - A�� <br /> /yr sl" )&e4f fb <br /> U <br /> (I/(� 3 T TAL DISBURSEMEN S 7 <br /> CURRENT CASH ON HAND <br /> TOTAL DISBURSEMENTS AND CASH ON HAND <br /> (SHOULD EQUAL TOTAL AUTHORIZED AMOUNT OF FUND) <br /> I certify that the above purchases were mad in accordance with Wright Motors of Lodi,CA policies and <br /> procedures for processing petty cash reimbursement. <br /> Reimbursement Che-1--4,q <br /> he- Date: Amount: <br /> Petty Cash O is Signature Date <br /> Created by LC <br /> Last printed 11/15/2004 10:32 AM <br />