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TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: Bank Account Number: GL Acct:
mm dd yyyy
Ending Bank Statement / GL Date: / / Bank Account Name:
Reconciliation
Bank Balance (per bank statement) $
Deposits in Transit Please check box at left if the detail is listed on the separate attached sheet.
DEPOSIT DATE DEPOSIT DESCRIPTION (including CR number) AMOUNT
/ / -
/ / -
/ / -
/ / -
/ / -
/ / -
ADD: Total Deposits in Transit -
Outstanding Payments / Adjustments Please check box at left if the detail is listed on the separate attached sheet.
PAYMENT DATE PAYEE NAME / DESCRIPTION AMOUNT
/ / -
/ / -
SUBTRACT: Total Outstanding Payments / Adjustments -
Adjusted Bank Balance $ -
General Ledger (GL) Balance
Bank Charges and NSF Chargebacks Please check box at left if the detail is listed on the separate attached sheet.
DATE CHARGED CHARGE / CHARGEBACK DESCRIPTION AMOUNT
/ / -
/ / -
SUBTRACT: Total Bank Charges and NSF Chargebacks -
Other GL Adjustments Please check box at left if the detail is listed on the separate attached sheet.
ADJUSTMENT DATE ADJUSTMENT DESCRIPTION AMOUNT
/ / -
/ / -
/ / -
/ / -
ADD: Total Other GL Adjustments -
Adjusted General Ledger Balance $ -
/ /
PREPARER NAME PREPARER SIGNATURE DATE PREPARED
/ /
REVIEWER NAME REVIEWER SIGNATURE DATE REVIEWED
Accounting Services Approvals
Accounting Services Initials Date
SUBMIT TO: STOP 6274 Form Updated August 2008
Lubbock Campus
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Deposits in Transit Detail (Please be sure that the applicable box on cover page is marked)
DEPOSIT DATE DEPOSIT DESCRIPTION (including CR number) AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Deposits in Transit -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Deposits in Transit Detail (Please be sure that the applicable box on cover page is marked)
DEPOSIT DATE DEPOSIT DESCRIPTION (including CR number) AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Deposits in Transit -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Deposits in Transit Detail (Please be sure that the applicable box on cover page is marked)
DEPOSIT DATE DEPOSIT DESCRIPTION (including CR number) AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Deposits in Transit -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Deposits in Transit Detail (Please be sure that the applicable box on cover page is marked)
DEPOSIT DATE DEPOSIT DESCRIPTION (including CR number) AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Deposits in Transit -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Deposits in Transit Detail (Please be sure that the applicable box on cover page is marked)
DEPOSIT DATE DEPOSIT DESCRIPTION (including CR number) AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Deposits in Transit -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Deposits in Transit Detail (Please be sure that the applicable box on cover page is marked)
DEPOSIT DATE DEPOSIT DESCRIPTION (including CR number) AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Deposits in Transit -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Outstanding Payments / Adjustments Detail (Please be sure that the applicable box on cover page is marked)
PAYMENT DATE PMT NBR / DOC ID PAYEE NAME / DESCRIPTION AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Outstanding Checks / Adjustments -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Outstanding Payments / Adjustments Detail (Please be sure that the applicable box on cover page is marked)
PAYMENT DATE PMT NBR / DOC ID PAYEE NAME / DESCRIPTION AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Outstanding Checks / Adjustments -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Bank Charges and NSF Chargebacks Detail (Please be sure that the applicable box on cover page is marked)
DATE CHARGED CHARGE / CHARGEBACK DESCRIPTION AMOUNT
/ /
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Bank Charges and NSF Chargebacks -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Bank Charges and NSF Chargebacks Detail (Please be sure that the applicable box on cover page is marked)
DATE CHARGED CHARGE / CHARGEBACK DESCRIPTION AMOUNT
/ /
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Bank Charges and NSF Chargebacks -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Other GL Adjustments Detail (Please be sure that the applicable box on the cover page is marked)
ADJUSTMENT DATE ADJUSTMENT DESCRIPTION AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Other GL Adjustments -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Other GL Adjustments Detail (Please be sure that the applicable box on the cover page is marked)
ADJUSTMENT DATE ADJUSTMENT DESCRIPTION AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Other GL Adjustments -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Other GL Adjustments Detail (Please be sure that the applicable box on the cover page is marked)
ADJUSTMENT DATE ADJUSTMENT DESCRIPTION AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Other GL Adjustments -
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Bank Reconciliation Form
General Information
Bank Name: 0 Bank Account Number: 0 GL Acct: 0
mm dd yyyy
Ending Bank Statement / GL Date: 0 / 0 / 0 Bank Account Name: 0
Other GL Adjustments Detail (Please be sure that the applicable box on the cover page is marked)
ADJUSTMENT DATE ADJUSTMENT DESCRIPTION AMOUNT
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VARIOUS SEE ADDITIONAL ATTACHED LIST
Total Other GL Adjustments -
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