DATE_________________

FUNDRAISING ACTIVITY:______________________________________

BUDGET CATEGORY:__________________________________________

FUNDS RECEIVED:

COINS: $_________________________

CURRENCY: $_________________________

CHECKS: $_________________________

TOTAL FUNDS RECEIVED $_____________________

The undersigned certify that the funds shown above were received for PTA activities and properly accounted for in accordance with the DDE PTA Money Management Policy, and are to be credited to the appropriate PTA account as noted.

Signature of Counter __________________ Date

Signature of Counter/Witness_______________________ Date__________

Committee Chair Signature _________________________ Date_________

Funds Forwarded to Treasurer on ___________ by ___________________

FOR TREASURER’S USE ONLY:

AMOUNT RECEIVED: $__________________ DATE________________

SPECIFIC BUDGET ITEM(S) CREDITED:___________________________

_____________________________________________________

COMMENTS:____________________________________________________

Treasurer’s Signature: _____________________________________________

DATE_________________

Signature of Counter ____________________________ Date__________

AMOUNT RECEIVED: $__________________ DATE________________

Signature of Counter __________________ Date

AMOUNT RECEIVED: $__ DATE