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When staffing levels do not permit separation of duties, compensating controls such as strict individual accountability and daily management review and supervision should exist. If no proper separation of duties, please specify compensating controls:  FORMTEXT       FORMTEXT       FORMTEXT      Provide a description of how the transactions will be identifiable / traceable to a specific cash handler.  FORMTEXT       FORMTEXT       FORMTEXT      Provide a description of the reconciliation process, including frequency of reconciliation.  FORMTEXT       FORMTEXT       FORMTEXT      Provide a description of the process for safeguarding cash until it is deposited.  FORMTEXT       FORMTEXT       FORMTEXT      Does the department use a petty cash change fund in the business operation?  FORMCHECKBOX  Yes  FORMCHECKBOX  No Amount of fund$ FORMTEXT      Name of the fund custodian FORMTEXT       DEPARTMENT SIGNATURES I understand that it is my responsibility to be familiar with the laws and regulations of the University of Louisiana at Lafayette and the State of Louisiana. I have read and understand the University s Funds Handling Policy and corresponding guidelines in its entirety and agree to adhere to all of the requirements of the policy. I also agree to adhere to the laws and regulations of the State of Louisiana. APPROVALS: TitlePrint NameSignatureDateRequested by (Requestor): FORMTEXT       FORMTEXT      Department Head FORMTEXT       FORMTEXT      Dean (if applicable) FORMTEXT       FORMTEXT       ADMINISTRATIVE AND FINANCIAL SERVICES OFFICE USE ONLY ApproveDeny FORMTEXT      Carrie Hebert Cash Compliance Analyst DateApproveDeny FORMTEXT      Angela Smith, CPA Associate ComptrollerDate ApproveDeny FORMTEXT      Jerry Luke LeBlanc Vice President for Administration and FinanceDate All requests and supporting documentation should be submitted to:Carrie Hebert Cash Compliance Analyst Financial Services  Comptroller s Office Martin Hall, Room 155A P.O. Box 40400 Lafayette, LA 70504 337-482-6287 % HYPERLINK "mailto:carrie.hebert@louisiana.edu"carrie.hebert@louisiana.edu Website: http://financialservices.louisiana.edu/ DISTRIBUTION:Original:Financial Services  Comptroller s OfficeCopy: Requesting Department / Requestor      PAGE \* MERGEFORMAT 4 | Page Funds Collection Request Form Revised 12/2023 - AMS FUNDS COLLECTION REQUEST  PAGE \* MERGEFORMAT 1 | Page Funds Collection Request Form Revised 12/2023 - AMS :Dlti` $IfgdZp `gd ^gd ^gdskd0$$Ifl '' t0644 la p ytHP”8:H DFHZ\^`bdfhjlnpź箥tmY&j'2he{h\ CJU\aJ h@" h\ &j1he{h\ CJU\aJhe{h\ CJ\aJ jhe{h\ CJU\aJh*MCJ\aJh@" h*MCJ\aJh\ 6CJ\aJh@" h*M6CJ\aJhmCJ\aJh6CJ\aJhq6CJ\aJhmhm6CJ\aJ"ln $IfgdZpskd1$$Ifl '' t0644 la p yt˜,<`fh˿˿~r^~&jC4he{h \CJU\aJhe{h \CJ\aJ jhe{h \CJU\aJh@" h \CJ\aJh \CJ\aJ h@" hB&j53he{hBCJU\aJhe{hBCJ\aJ jhe{hBCJU\aJ h@" h\ huh\ CJ\aJ jhe{h\ CJU\aJ" $IfgdZpskd2$$Ifl '' t0644 la p yt˜wn $Ifgd  & F uh`ugdskd3$$Ifl '' t0644 la p yt™ęؙڙܙޙ 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