<p> PETTY CASH REPLENISHMENT REPORT (PCRR) INSTRUCTIONS A. This report shall be accomplished as follows: 1. Agency – name of the agency 2. Period Covered - period covered by the report 3. Report No. - assigned report number which shall be as follows: 000-00-00-000 Serial number (one series for each year) Month Year Petty Cash Custodian Code 4. Sheet No. – page number 5. Date – date of the Petty Cash Voucher (PCV) 6. Petty Cash Voucher No. – the serial number of the PCV to be presented in numerical order 7. Particulars – nature of disbursements/expenses as shown in the PCV 8. Amount – amount paid covered by the voucher 9. Certification - name and signature of the designated Petty Cash Custodian (PCC) and date of signing B. This report shall be used for replenishment of the Petty Cash Fund. All liquidated PCVs shall be attached together with all the supporting documents. C. The PCC shall prepare this report in two copies distributed as follows: Original – Accounting Unit as attachment to the Disbursement/ Replenishment Voucher together with the original of the PCVs and supporting documents Duplicate Copy – PCC File </p><p>D. At the end of the year, the PCC shall submit all paid PCV for replenishment to record expenses incurred. ______AO 6/15/02</p><p>128</p>