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Itemized Receipt Form
(To be used when giving funds to Treasurer)
Chairman Phone No.
Person completing form Phone No.
(Please make sure that there are always 2 people counting money to protect thereliability of the count)
Total of checks (attach a tape/written account)$
Total Bills $
Total Coins $
Total Cash $
Total Deposit $
Counter’s Signature Date
Received by Treasurer Date
(When turning in a deposit, please allow time for another count of the total deposit so a receipt can be given to the
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