Cash Reconciliation Log 
Instructions: Use this form to document, justify, reconcile, and in some situations replenish, Authorized Miscellaneous Payment Funds.
PV # ______________________________________________
Department:__________________________________________________

Contact for Questions:_______________Phone_____________

Transactions for the Period
from:________ to :________		 CUFS Account :
______/_____/_______/______/_____/
AreaOrgSuborgObj Subobj
Amount of initial advance, or Ending Balance from previous CRL (if replenishing)   $ _________________
Transaction
Date		 Payment Made to Justification of Expense Amount of
expense 		Amount of
deposit		 Balance
      
      
      
      
      
      
      
      
      
      
      
      
Ending Cash Balance (Beg Balance + or - cash activity= cash on hand)  $ _________________
Total Cash Request, if replenishing (Beg. Bal - End Bal)  $                  

I certify the above expenditures are valid,
reasonable and allowable on this budget.

__________________________________Date_______
Signature of Employee Reconciling Cash

I certify the above expenditures have been
reconciled and are appropriate.

__________________________________Date_______
Signature of Departmental Authorized Signer

Route: Approved document, Cash Reconciliation Log and Receipts to: Disbursement Services
Exception Processing
Suite 645 WBOB, 1300 So. 2nd St. Mpls., MN 55454

INSTRUCTIONS

Cash Reconciliation Log (CRL) Instruction

Use this form to record, justify, reconcile, and in some situations replenish, Authorized Miscellaneous Payment Funds.

Field #DesignationComments
1.Required:Insert the PV number used to request the cash, in the cash of replenishment, use the PV number for the original request.
2.Required:Name of the department
3.Required:Contact person to call if there are questions.
4.Required:Telephone number of the contact person.
5.Required:Period during which the expenditures were made
6.Required:CUFS Area number
7.Required:CUFS Org number
8.Conditional:Required if your department uses a SubOrg
9.Required:CUFS Object number
10.Required:CUFS SubObj number
11.Required:Beginning Balance, the dollar amount of the original request, or the Ending Cash Balance from previous CRL
12.Required:Date the expenditure was made, or when cash was received for replenishment.
13.Required:Name of the vendor or individual for which cash was used, or PVA# for the most recent cash replenishment
14.Required:Adequate information to describe and justify the expenditure (what and why)
15.Required:Amount of the expenditure, or amount of cash replenished.
16.Required:Total any cash received minus expenditures made, arriving at an Ending Cash Balance that equals cash on hand. This is the Beginning Cash Balance on the next CRL, if replenishing.
17.Required:Subtract Ending Cash Balance from Beginning Cash Balance to determine the amount of replenishment.
18.Required:Signature of the employee reconciling cash
19.Required:Signature of an authorized departmental signer

REMINDER:

  • Attach original itemized receipts, if missing a receipt, attach explanatory signed statement detailing use of cash.
  • Ensure reconciliation has occured.
  • Maintain copy of the CRL in your department.
  • Submit completed CRL and receipts per routing instructions below.
  • Cash Reconciliation Logs received without all required signatures will be returned.

    ROUTING:
    Disbursement Services, Exception Processing Suite 645 WBOB, 1300 South Second Street, Minneapolis MN 55454

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    http://www.fpd.finop.umn.edu/groups/ppd/documents/Form/crl_form.cfm
    Updated: November 6, 2006