Petty Cash Float Request Form

Guidance:

This form is to be used exclusively for any initial request for the operation of a locally controlled petty cash float, or alternatively any amendment to the level of a float previously agreed.

Any amendments/completed forms must be returned to the Financial Controller at Head Office, who will hold records of the information provided for safekeeping and audit purposes and will advise you on the outcome of your request.

Please retain a copy locally of this completed form, before returning the original to Head Office.

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Establishment:

Type of Request:

New float ☐

Decrease to an existing float ☐

Increase to an existing float ☐

Float Level Required:

£100 ☐ £200 ☐ £250 ☐

£300 ☐ £350 ☐ £400 ☐

£450 ☐ £500 ☐ £OTHER ☐

If other please specify:

Petty Cash Float Request Form Mar 15

£

Please state the business case reason for this request:

Expected Expenditure Will Cover: (Please tick all that apply)

Food: ☐ Travel: ☐ Arts/Crafts: ☐

Cleaning Materials: ☐ Flowers: ☐ Postage: ☐

Stationary: ☐ Toiletries: ☐ Medical: ☐

Magazines: ☐ Social Trips: ☐ IT Suppliers: ☐

Other: ☐ (If other please specify): …………………………………..

I certify that the above is a formal request to operate/amend a petty cash float system at my authorised establishment and confirm that I have read and fully understood the outlining procedures, including my responsibilities, in operating such a system as defined in the financial procedures manual.

Name …………………………………………………………

Signed …………………………………………………………

Position …………………………………………………………

Date …………………………………………………………

Head Office Finance (Financial Controller Only):

Authorised (yes/no): ……………………………………………………...

Float Level Approved: £……………………………………………………

Name …………………………………………………………

Signed …………………………………………………………

Date …………………………………………………………

Petty Cash Float Request Form Mar 15

(Please give as much detail as possible that will support your request)