National Charity League, Inc.
CASH VERIFICATION FORM
Received From:
________________________________________ Date: _____________________
Event:
__________________________________________________________________________
Coins:
Pennies ______________________
Nickels ______________________
Dimes ______________________
Quarters ______________________
Others ______________________
Total $______________________
Currency:
$ 1.00 ______________________
$ 5.00 ______________________
$
10.00 ______________________
$
20.00 ______________________
Other ______________________
Total $______________________
Checks:
______________________ ______________________ ______________________
______________________ ______________________ ______________________
______________________ ______________________ ______________________
______________________ ______________________ ______________________
______________________ ______________________ ______________________
______________________ ______________________ ______________________
______________________ ______________________ ______________________
Total
$______________________
Grand Total
$______________________
VERIFICATION:
Signature:
____________________________ Signature:
_________________________