Haynes Bridge Middle School PTA
INCOME Remittance Form

(Print out this form and turn it in to the Treasurer's folder in the front office of the school)

 Please submit this form with all checks and cash given to the Webb Bridge PTA Treasurer.

 NAME:_________________________________________________________________________

 PHONE:________________________________________________________________________

TOTAL COINS:                          ______________________________

TOTAL CURRENCY:                  ______________________________

TOTAL CHECKS:                      ______________________________

TOTAL CASH & CHECKS:         ______________________________

  BUDGETED AREA OR EVENT WHERE FUNDS WERE OBTAINED:

_______________________________________________________________________________

The undersigned certifies that the funds shown above were received for PTA activities and are properly accounted for. They are to be credited to the appropriate PTA account as noted.

SIGNATURES:________________________________________________________

                      _______________________________________________________

  ..............................................................................................................................................

DO NOT WRITE BELOW THIS LINE

Date of deposit               _______________________________________

Deposit Number             _______________________________________

Total Amount of Deposit             _______________________________________

Budgeted Area Credited             _______________________________________