A copy of the June bank statement for the Petty Cash Account must be included with the completed CO-928 Annual Petty Cash Report.
For your convenience, the CO-928 Annual Petty Cash Report form can be found under the forms section of the Comptroller’s Website under All Categories - “Petty Cash/Trustee”.
Certification by the Agency Head or a designated management-level employee is required. Please note that the individual listed in the “Prepared By” field must be different from the individual signing as “Agency Head/Authorized By.”
If there are any questions regarding the Annual Petty Cash Report (CO-928), please send an email to osc.pettycash@ct.gov.