RECEIPTS
MONTH OF ______________ TOTAL AMOUNT RECEIVED
RECEIPTS ISSUED DATE FROM NO. THROUGH NO. $
DEPOSITS No. @ $ -
INITIATION FEES No. @ $ AMOUNT -
DUES NO. OF MONTHS AMOUNT $ NO.
REINSTATEMENT FEES AMOUNT $ NO.
WORK PERMIT FEES AMOUNT $ NO.
ASSOCIATE MEMBERSHIP AMOUNT $ AMOUNT $ -
MISCELLANEOUS EXPLANATION
-
$
-
TOTALS
$
-
$
-
$
-
$
-
$
-
$
-
$
-
$
-
$
-
DISBURSEMENTS
PAID TO CHECK NUMBER FOR (Describe Purpose of Payment) $ AMOUNT
DATE
Bank Service Charge (if any) for this month Total $ -
NONCHARGEABLE DISBURSEMENTS
PAID TO CHECK NUMBER FOR (Describe Purpose of Payment) $ AMOUNT
DATE
Bank Service Charge (if any) for this month Total $ -
MONTH OF ______________ CHECKING ACCOUNT RECAPITULATION Balance in checking account(s) last day of last month Plus total receipts during this month Total Less total disbursements during this month Balance in checking account(s) last day of this month RECONCILEMENT OF CHECKING ACCOUNT(S) Balance according to bank statement(s) Plus deposits for month not shown on Bank Statement(s) Less total amount of checks outstanding (see: outstanding) Balance in checking account(s) last day of this month $ $ $ $ $ $ $ -
TOTAL ASSETS RECAPITULATION LAST DAY OF THIS MONTH Checking account(s) Name of Bank: Name of Bank: Name of Bank: Name of Bank: Name of Bank: Savings account(s): Name of Bank: Name of Bank: Name of Bank: Name of Bank: Name of Bank: Petty Cash Securities, Bonds - itemize $ -
$
-
$ $
-
Defense or Strike Fund Welfare Funds
$ $ Total assets last day of this month $
-
OUTSTANDING CHECKS
PAID TO CHECK NUMBER $ AMOUNT
DATE
TOTAL OUTSTANDING
$
-