BERITA ACARA PEMERIKSAAN KAS

Pada hari ini …………………. Tanggal …………………. , berdasarkan Surat Tugas
………………… nomor: …………………………….. tanggal .......................... telah
dilakukan pemeriksaan kas oleh Tim Audit yang terdiri dari:
1. N a m a
Jabatan

: …………………………………………
: Anggota Tim

2. N a m a
Jabatan

: …………………………………………
: Ketua Tim

terhadap
Nama
Jabatan
SK Kasir No/Tgl

: ………………………………………..
: Kasir PT Graha Artha Nusantara
: ...............................................................

dengan hasil pemeriksaan sebagai berikut:
Saldo menurut Buku
Rp .......................
Saldo menurut pemeriksaan fisik ” .......................
Selisih lebih (kurang) Rp .......................
Selisih tersebut disebabkan:
................................................................................................................
................................................................................................................
................................................................................................................
Jakarta, ..............................................
Yang diperiksa

Pemeriksa I

(......................................................)
Kasir

(......................................................)
Anggota Tim
Pemeriksa II

(......................................................)
Manajer Keuangan

(......................................................)
Ketua Tim

.... Surat Berharga 1................................................. Rp .....................00 Rp 5......... Rp ................. lembar .....00 Rp 1..) Anggota Tim Pemeriksa II (........ 2............ Rp ........................................... Penjelasan selisih: ...............tgl …….............Rincian Hasil Pemeriksaan Kas Tanggal : ....................................................00 Rp 500...................... Saldo menurut Buku Harian Kas .............. Check BRI No………...................... 3.....00 500... ....000...............00 100.... Rp ...... Rp . ” .............. Rp ..) Kasir (................................ Rp ............. Total uang rupiah ............................ Rp . Rp ….............00 200.. lembar .................................................................. lembar .......... Jakarta.................... lembar ................... Rp ….. Rp .. lembar ..................00 50.. Uang Logam .................................................00 = = = = = = = = Rp .................................. Uang Kertas: ... lembar ...................00 Rp 10......000................ Rp ....................000... Rp .................................................... lembar ............ lembar x x x x x x x x Rp 100...... lembar .... lembar ......... Yang diperiksa Pemeriksa I (..... Rp ...000................ Rp .................. Rp .. Selisih lebih (kurang) ..............000...........tgl …… = = = = Rp ................................... keping ..00 25............ Rp ….. Rp ..................) Manajer Keuangan (............ Rp ................................... ...00 = = = = = = Rp ...........................00 Rp 100..........000..... lembar x x x x x x Rp Rp Rp Rp Rp Rp 1.......00 Rp 20...................................................... Check BNI No…….......................................................... Rp .) Ketua Tim .........00 Rp 50..........000.......................................... lembar ...... Total hasil pemeriksaan kas .....................tgl ….......................... Check BCA No………... Rp ......................................... lembar ..

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