A	B	C	D	E	F	G	H	I	J
1	Reconciliation of Imprest Checking Account
2
3	Reconciliation of Imprest Checking Account #
4	For the Month of _________ , ______					Account Title
5						Location
6
7		BASE AMOUNT OF THIS ACCOUNT					$
8
9		BANK STATEMENT ENDING DATE
10
11	BALANCED TO BANK STATEMENT/CHECKBOOK REGISTER:
12
13		Ending Balance on bank statement						$
14
15		Less outstanding checks listed below						(		)
16
17		Plus deposits in register not yet on bank statement
18
19		Less deposits on statement not yet in register
20
21			BALANCE (to agree with balance in					$
22			checkbook register) at check number ______
23
24	(IF YOUR BALANCE IN YOUR CHECKBOOK DOES NOT AGREE WITH THE BALANCE
25	ABOVE, PLEASE LOCATE THE CAUSE AND CORRECT IT NOW. IF YOU NEED ASSISTANCE
26	CALL THE ACCOUNTING OFFICE EXTENSION 4175.)
27
28	ACTIVITY RECONCILED TO BASE AMOUNT OF IMPREST ACCOUNT:
29
30		Balance in checkbook register
31		(Should be the same as balance above)
32
33		Plus change funds* check#					+	$
34		(* Not applicable for General Fund)
35
36		Plus reimbursements in process					+
37		(ck# ___________thru # ____________)
38
39			Total: (Should agree with base amount)					$
40
41	Completed by							Date:
42
43	Reviewed by							Date:
44
45	Outstanding Checks:			#		$		#		$
46				#		$		#		$
47				#		$		#		$
48				#		$		#		$
49				#		$		#		$
50				#		$		#		$

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