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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

Rincian Hasil Pemeriksaan Kas


Tanggal : .......................
Uang Kertas:
............ lembar
............ lembar
............ lembar
............ lembar
............ lembar
............ lembar
............ lembar
............ lembar

x
x
x
x
x
x
x
x

Rp 100.000,00
Rp 50.000,00
Rp 20.000,00
Rp 10.000,00
Rp 5.000,00
Rp 1.000,00
Rp
500,00
Rp
100,00

=
=
=
=
=
=
=
=

Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ....................

Uang Logam
............ keping
............ lembar
............ lembar
............ lembar
............ lembar
............ lembar

x
x
x
x
x
x

Rp
Rp
Rp
Rp
Rp
Rp

1.000,00
500,00
200,00
100,00
50,00
25,00

=
=
=
=
=
=

Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ......................
Rp ....................
Total uang rupiah ...... Rp ...................

Surat Berharga
1. Check BNI No...............tgl ....
2. Check BRI No............tgl .
3. Check BCA No............tgl

=
=
=
=

Rp ......................
Rp ...................
Rp ...................
Rp ...................

Rp ....................
Total hasil pemeriksaan kas .......... Rp ....................
Saldo menurut Buku Harian Kas .......... ....................
Selisih lebih (kurang) .......... Rp ....................

Penjelasan selisih:
............................................................................................................................
............................................................................................................................
Jakarta, ..............................................
Yang diperiksa

Pemeriksa I

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

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

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

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