Get documents about "Cash Receipt for a Loan Agreement
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Cash Receipt for a Loan Agreement document sample
Document Sample
North Carolina Department of Health and Human Services Institution Name:
SUMMER FOOD SERVICE PROGRAM Institution Number:
CASH RECEIPTS AND DISBURSEMENTS JOURNAL Claim Month/Year:
BANK ACCOUNT FUNDS AVAILABLE DURING THE MONTH APPLICATION OF FUNDS DURING THE MONTH
D
Beginning Program Non-Program Balance
a USDA Reimburse- Admin Loan
Description Check # Deposits Expenditures Fund Adult Meal Adult Meal Loans to Program Food Labor Supplies Other Equipment Total Epenses Carried
t ment Total Funds avaiable Salary Repayment
Balance Payments Payments Forward
e
BALANCE BROUGHT FORWARD 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
BALANCE CARRIED FORWARD 0 0
TOTAL (or SUB-TOTAL) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DHHS CAC 5 (03/05)
Nutrition Services RETAIN IN YOUR FILES. DO NOT MAIL TO STATE AGENCY.
INSTRUCTIONS FOR THE
CASH RECEIPTS AND DISBURSEMENTS JOURNAL
The purpose of the Cash Receipts and Disbursements Journal is to record daily financial transactions for each
month of program operations. Cash basis accounting is utilized for the purpose of accounting for reimbursement for the
the Summer Food Service Program. All financial program transactions must be recorded on the date they occur.
Additional sheets are to be used, if necessary, to record all transactions for the month.
Transactions
Date - Enter the actual date of the transaction.
Description - Enter the person, vendor, etc., from whom a deposit is received or to whom a payment is made.
Check Number - Enter the number of the check for this transaction, if any.
Deposits - Enter the amount of the deposit made or credited to the Summer Food Service Program account.
Expenditures - Enter the amount of the SFSP expenditure made from the Summer Food Service Program
account.
Funds Available During the Month
Beginning Fund Balance - Enter the beginning SFSP fund balance. This will be
the same amount as the balance carried forward calculated at the end of the previous month.
Non-Program Adult Meal Payments - Enter the amount of the adult meal payment received and deposited in,
or credited to the SFSP Account.
Catered Meal Payments - Enter the amount of the catered meal payment received and deposited in, or credited
to the SFSP Account.
Sponsor Contributions - Enter the amount of the sponsor contribution received and deposited in, or credited to
the SFSP Account. These are funds that are not expected to be repaid to the institution.
USDA Reimbursement - Enter the amount of the USDA reimbursement check received and deposited
in, or credited to the SFSP Account. (All interest earned on program funds must remain in the
program for program use only)
Loans to Program - Enter the amount of loans made to the SFSPAccount by either depositing in or crediting
to the Program Income. These are funds that are expected to be repaid to the institution.
Applications for Funds During the Month
(Each transaction is recorded separately)
Food - Enter the amount of funds expended or debited for food for enrolled participants. The cost must be
supported by an itemized receipt, invoice, monthly statement, and canceled check (when a check is
written.)
Administrative Salary - Enter the amount of funds expended or debited for salaries, plus fringe benefits. This
must be supported by time sheets showing all time worked with SFSP time
denoted, in addition to payroll records including payroll tax records, and canceled checks.
Labor - Enter the amount of funds expended or debited for labor and fringe benefits to food service workers. This
amounts includes costs for storage, preparation, supervision, and service of meals. It must be supported
by completed time sheets, payroll records including payroll tax records, and canceled checks.
Supplies - Enter the amount of funds expended or debited for food service supplies. The cost must be budgeted and supported
by an itemized receipt, invoice, monthly statement, and canceled check (when a check is written).
Other - Enter the amount of funds expended or debited for miscellaneous other program costs as approved per
your agreement and which are not included in the above costs or equipment. The cost must be budgeted and supported
by an itemized receipt, invoice, monthly statement, and canceled check ( when a check is written).
Equipment - Enter the amount of program funds expended or debited for program equipment . Remember: Only
items with a unit price exceeding $500, and having a useful life exceeding two years, and prior approval of
the State Agency are to be recorded as Equipment. Depreciation records must be maintained and
monthly depreciation must be maintained.
The cost must be supported by an itemized receipt, invoice, monthly statement, and canceled check
(when a check is written).
Loan Repayment - Enter the amount repaid for any documented program loans, not to exceed the actual amount
of the loans. (Interest is not an allowable expense.)
Balance Carried Forward - Enter the balance, if applicable, after all expenses and loan repayment have been paid.
Total (SUBTOTAL) Total each column.
RETAIN IN YOUR FILES. DO NOT MAIL THIS FORM WITH YOUR CLAIM FOR
REIMBURSEMENT.
DHHS CAC (03/05)
Nutrition Services
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