Page _____of_____ - Ohio
Page _______of_______
Petty Cash Account Quarterly Report
as of _________________
(date)
Agency: ____________________ Petty Cash Account Coordinator: ________________________________________
(name) (phone)
| |
|OBM ACCOUNT ID NUMBER* |
| |
| |
complete to the best of my knowledge.
_______________________________
Send to: obmpettycash@obm. or Coordinator signature
OBM 7275 Office of Budget and Management, State Accounting, 30 E. Broad Street
Revised 1/2016 34th Floor Columbus, Ohio 43215-3457
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