Appendix 80

Name of the Agency

Cash - MDS, Regular
Monthly Reconciliation Statement
As of ____________________

Fund Cluster: __________________

Particulars
Unadjusted Balances
Add/Deduct: Bank
Reconcilng Items
1. Unrecorded NCA
2. Errors which understates the
bank balance
3. Lapsed NCA
4. Outstanding Checks
5. Errors which overstates the
bank balance
Add/Deduct: Agency Book
Reconcilng Items
1. Unrecorded NCA
2. Cancelled Checks
3. Errors which understates the
book balance
4. Lapsed NCA
5. Errors which overstates the
book balance
6. Bank Charges
Adjusted Balances

Agency
xxx

Bank

Explanatory Comment
xxx

xxx

See Schedule ___

xxx
(xxx)
(xxx) See Schedule ___
(xxx)

xxx
xxx

NCA No. ____

See Schedule ___

xxx
(xxx)

CM No. ____
See Schedule ___

(xxx)
(xxx)
xxx

DM No. ____
DM No. ____

Prepared by:

xxx

Certified Correct:

_____________________________
(Name & Designation)
______________________
Date

_____________________________
(Name & Designation)
______________________
Date

195