County of .............
Date .............
Amount Per Bank Statement Dated . . . . . . . . . . . . .
ADD: Deposits in transit (Receipts recorded in Cash Receipts Journal not shown on this bank statement)
$ .00 DATE RECEIPT NO
AMOUNT $ .00 .00 .00 $ .00 DEDUCT: Outstanding Checks (Checks issued and dated prior to date of bank statement per Cash Disbursements Journal not having yet cleared the bank)
DATE PAYEE RECONCILED BALANCE AMOUNT $ .00 .00 .00 .00 $ .00 This reconciled balance shall agree to either the cash balance as shown on the official’s check stubs running bank balance, or the official’s general ledger cash balance, whichever system the official employs
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