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U.S. ARMY SOLDIER SUPPORT INSTITUTE NONCOMMISSIONED OFFICER ACADEMY FINANCIAL MANAGEMENT ADVANCED LEADERS COURSE 36B Identify Daily Accountable Transactions PRACTICAL

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Page 1: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

U.S. ARMY SOLDIER SUPPORT INSTITUTE NONCOMMISSIONED OFFICER ACADEMY

FINANCIAL M A N A G E M E N T ADVANCED LEADERS

COURSE 36BIdentify Daily Accountable Transactions

PRACTICAL EXERCISE

VERSION 1.0

March 2014

Page 2: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

Identify Daily Accountable Transactions PE

STUDENT INSTRUCTIONS

OBJECTIVE: This practical exercise measures your ability to reconcile an agent’s daily transaction/business day with their DD 1081.

General Information:

A. Disbursing Agent (DA): YouB. Deputy Disbursing Officer (DDO): CPT John DoerrC. Disbursing Officer (DO): James R. Richardson, LTC, FCD. Cashier: Cashier #1E. DSSN: 6348F. Business Date: 1 December 2013G. Exchange Rate: 3 Foreign Currency (FC) : 1 US CurrencyH. Beginning Balance: $15,000.00 from the previous dayI. Return: $ 4,300.00; (FC) ($2,200) 6,600 J. Cash on Hand COB 1 December: $5,650.80 US; 11,652.60 FC ($3,884.20)

Instructions: You are assigned as the Disbursing Manger for the 23rd FMSU, but have taken over as the Disbursing Agent while they are on leave. Today’s business date is 1 December 2013. Your cashier has had trouble balancing out and has asked you to review their DD 1081 and identify what the cashier’s mistake(s) is/are and what should be the correct amount(s) needed to balance out. You will be given the all of the cashier’s documents from today’s business date, along with their trial DD 1081.

Information Verified as correct:

1. Beginning Balance2. US/Foreign Currency returned verified as correct3. Description of the Exchange Transactions listed below4. Description of the Collection/Disbursement vouchers are correct as listed below5. Assume the ECC Loads/Sales report and Batch List are correct as listed

Page 3: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

Exchange Transaction Information

Listed below are the exchange transactions completed by the cashier:

1. PFC Jones cashed a personal check for $200.2. CPT Kingston cashed out $150 off of his ECC for foreign currency.3. 2LT Evans exchanged $200 for credit on her ECC.4. SSG Lowe cashed $150 personal check for credit on his ECC.5. SPC Halstead cashed out $165 off of her ECC for cash.6. MAJ Waters cashed a $150 personal check for cash.7. SGT Calhoun cashed out $85 off her ECC for foreign currency.8. CW3 Anderson exchanged $225 for credit on her ECC.9. SFC Snow cashed a $300 personal check for foreign currency.10.A1C Dent cashed out $175 off his ECC for cash.11.LCpl Nieves exchanged $300 cash for credit on her ECC.12.LTC Matthews cashed out $275 off her ECC for cash.13.GySgt Brown cashed a $165 personal check for credit on his ECC.14.TSgt Eamon exchanged $75 and 225 FC for credit to his ECC.15. 1LT Ingles exchanged 180 FC for credit to her ECC.

Collection/Disbursement Voucher Information: 1. CPT Underwood made a SDP deposit for $3,000.00 with a personal check2. A1C Waters paid his GPLD for $542.33 with a personal check3. SPC Martin made a SDP deposit for $2,365 with his ECC4. GySgt Blackmon made a SDP deposit for $3,700.00 with a personal check5. LCpl Dewese made a SDP deposit for $1,500.00 with a personal check6. PFC Sweeney made a SDP deposit for $1,000.00 with a personal check7. SPC Scales paid his GPLD for 205.33 with a personal check8. CPT Moore paid $2,294.00 in overpayment of entitlements with a personal check9. PO1 Cole made a SDP deposit for $2,550.00 with her ECC

Page 4: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

DD Form 1081, MAY 75 PREVIOUS EDITION IS OBSOLETE. Adobe Professional 8.0

STATEMENT OF AGENT OFFICER’S ACCOUNTDISBURSING OFFICER’S NAME, ADDRESS, DISBURSING STATION SYMBOL NO.

Your Name DISBURSING AGENT 23RD FMSUAPO AE 09808

AGENT OFFICER’S NAME, GRADE, SSN, UNIT ADDRESS(Include ZIP Code/APO number) and Telephone number)

Cashier #1 XXX-XX-XXXX 23RD FMSU APO AE 09808

TRANSACTIONS AFFECTING AGENT OFFICER’S ACCOUNT

TRANSACTIONSa

INCREASE(Received by Agent)

b

BEGINNING BALANCE(In Agent’s Account) c

DECREASE(Turned in by

Agent) d

ENDING BALANCE(In Agent’s

Account) e

1. BALANCE FORWARD 33,000.00 51,407.632. U.S. DOLLARS 4,300.003. FOREIGN CURRENCY 2,200.004. MILITARY PAYMENT CERTIFICATES

5. COLLECTIONS 17,157.636. DEPOSITS

7. NEGOTIABLE INSTRUMENTS

A. TREASURY CHECKS

B. MILITARY PAYMENT ORDERS

C. OTHER (Specify) Checks 13,207.638. PAID VOUCHERS 16,400.009. INCORRECT VOUCHERS RETURNED

10. SVC/ECC Loads 1,250.0011. SVC/ECC Sales 5,765.0012. TOTAL FUNDS IN HANDS OF AGENT OFFICER 51,407.63 9,535.00

STATEMENTSDISBURSING OFFICER AGENT OFFICER

ON ADVANCE: I HAVE INTRUSTED FUNDS AND/OR OTHER ITEMS AS INDICATED IN THIS STATEMENT TO THE ABOVE NAMED AS MY AGENT OFFICER.

ON ADVANCE: I, AS AGENT OFFICER, HAVEFUNDS AND/OR OTHER ITEMS AS INDICATED ABOVE. I HAVE ASSUMED PECUNIARY RESPONSIBILITY THEREFOR. I WILL NOTIFY THE DISBURSING OFFICER IMMEDIATELY UPON DISCOVERY OF ANY LOSS OR SHORTAGE, AND I HAVE RECEIVED AND UNDERSTAND WRITTEN INSTRUCTIONS CONCERNING MY DUTIES AND RESPONSIBILITIES AS AN AGENT OFFICER.

DATE SIGNATURE OF DISBURSING OFFICER DATE SIGNATURE OF AGENT OFFICER

X ON RETURN: I HAVE RECEIVED FUNDS AND/OR X ON RETURN: THE ABOVE STATEMENT OF ACCOUNTITEMS AS INDICATED ON THIS STATEMENT FROM THE ABOVE NAMED AGENT OFFICER.

IS CORRECT.

Page 5: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

DD Form 1081, MAY 75 PREVIOUS EDITION IS OBSOLETE. Adobe Professional 8.0

DATE

1 Dec 2013SIGNATURE OF DISBURSING OFFICER

/S/

DATE

1 Dec 2013SIGNATURE OF AGENT OFFICER

/S/

Page 6: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

DD Form 1081, MAY 75 PREVIOUS EDITION IS OBSOLETE. Adobe Professional 8.0

STATEMENT OF AGENT OFFICER’S ACCOUNTDISBURSING OFFICER’S NAME, ADDRESS, DISBURSING STATION SYMBOL NO.

Your Name DISBURSING AGENT 23RD FMSUAPO AE 09808

AGENT OFFICER’S NAME, GRADE, SSN, UNIT ADDRESS(Include ZIP Code/APO number) and Telephone number)

Cashier #1 XXX-XX-XXXX 23RD FMSU APO AE 09808

TRANSACTIONS AFFECTING AGENT OFFICER’S ACCOUNT

TRANSACTIONSa

INCREASE(Received by Agent)

b

BEGINNING BALANCE(In Agent’s Account) c

DECREASE(Turned in by

Agent) d

ENDING BALANCE(In Agent’s

Account) e

1. BALANCE FORWARD 15,000.00 33,000.002. U.S. DOLLARS 12,000.003. FOREIGN CURRENCY 6,000.004. MILITARY PAYMENT CERTIFICATES

5. COLLECTIONS

6. DEPOSITS

7. NEGOTIABLE INSTRUMENTS

A. TREASURY CHECKS

B. MILITARY PAYMENT ORDERS

C. OTHER (Specify)

8. PAID VOUCHERS

9. INCORRECT VOUCHERS RETURNED

10.

11.

12. TOTAL FUNDS IN HANDS OF AGENT OFFICER 33,000.00 33,000.00STATEMENTS

DISBURSING OFFICER AGENT OFFICER

X ON ADVANCE: I, AS AGENT OFFICER, HAVEFUNDS AND/OR OTHER ITEMS AS INDICATED ABOVE. I HAVE ASSUMED PECUNIARY RESPONSIBILITY THEREFOR. I WILL NOTIFY THE DISBURSING OFFICER IMMEDIATELY UPON DISCOVERY OF ANY LOSS OR SHORTAGE, AND I HAVE RECEIVED AND UNDERSTAND WRITTEN INSTRUCTIONS CONCERNING MY DUTIES AND RESPONSIBILITIES AS AN AGENT OFFICER.

X ON ADVANCE: I HAVE INTRUSTED FUNDS AND/OROTHER ITEMS AS INDICATED IN THIS STATEMENT TO THE ABOVE NAMED AS MY AGENT OFFICER.

DATE

1 Dec 2013SIGNATURE OF DISBURSING OFFICER

/S/DATE

1 Dec 2013SIGNATURE OF AGENT OFFICER

/S/

ON RETURN: I HAVE RECEIVED FUNDS AND/ORITEMS AS INDICATED ON THIS STATEMENT FROM THE ABOVE NAMED AGENT OFFICER.

ON RETURN: THE ABOVE STATEMENT OF ACCOUNT IS CORRECT.

Page 7: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

DD Form 1081, MAY 75 PREVIOUS EDITION IS OBSOLETE. Adobe Professional 8.0

DATE SIGNATURE OF DISBURSING OFFICER DATE SIGNATURE OF AGENT OFFICER

Page 8: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

CASH COLLECTION VOUCHER

1. DISBURSING OFFICE COLLECTION VOUCHER NUMBER473156

2. RECEIVING OFFICE COLLECTION VOUCHER NUMBER

3. RECEIVING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

b. RECEIVED AND FORWARDED BY (Printed Name, Title and Signature) d. DATE (YYYYMMDD)

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:

4. DISBURSING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

23rd FMSUAPO,AE 09098

b. DISBURSING OFFICER (Printed Name, Title and Signature)/S/

JAMES R. RICHARDSON, LTC, FC, CMD

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:555-5555

5. PERIOD: a. FROM: b. TO:

c. DISBURSING STATION SYMBOL NUMBER

6348d. DATE (YYYYMMDD)

20131201

6. DATE RECEIVED 7. NAME OF REMITTER

DESCRIPTION OF REMITTANCE8. DETAILED DESCRIPTION OF

PURPOSE FOR WHICHCOLLECTIONS WERE RECEIVED

9. AMOUNT 10. ACCOUNTING CLASSIFICATION

1Dec13 CPT Harold Underwood 127th TSBAPO, AE 09098555-86-9453

SDP Deposit Check # 113

$3,000.00 21X201011D11A76VV76VV0065 7000.10K7 74983QLOG 1631497000000

PC

11. TOTAL $3,000.00

DD FORM 1131, DEC 2003 PREVIOUS EDITION IS OBSOLETE.

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CASH COLLECTION VOUCHER

1. DISBURSING OFFICE COLLECTION VOUCHER NUMBER473157

2. RECEIVING OFFICE COLLECTION VOUCHER NUMBER

3. RECEIVING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

b. RECEIVED AND FORWARDED BY (Printed Name, Title and Signature) d. DATE (YYYYMMDD)

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:

4. DISBURSING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

23rd FMSUAPO,AE 09098

b. DISBURSING OFFICER (Printed Name, Title and Signature)/S/

JAMES R. RICHARDSON, LTC, FC, CMD

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:555-5555

5. PERIOD: a. FROM: b. TO:

c. DISBURSING STATION SYMBOL NUMBER

6348d. DATE (YYYYMMDD)

20131201

6. DATE RECEIVED 7. NAME OF REMITTER

DESCRIPTION OF REMITTANCE8. DETAILED DESCRIPTION OF

PURPOSE FOR WHICH 9. AMOUNT COLLECTIONS WERE RECEIVED

10. ACCOUNTING CLASSIFICATION

1Dec13 A1C Taylor Waters576th AMC APO, AE 09098555-88-7465

GPLDCheck # 68

542.33 573202011D11A76VV76VV0065 5000.10K7 796541KNAQ 542189000000

PC

11. TOTAL 542.33

DD FORM 1131, DEC 2003 PREVIOUS EDITION IS OBSOLETE.

Page 10: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

CASH COLLECTION VOUCHER

1. DISBURSING OFFICE COLLECTION VOUCHER NUMBER473158

2. RECEIVING OFFICE COLLECTION VOUCHER NUMBER

3. RECEIVING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

b. RECEIVED AND FORWARDED BY (Printed Name, Title and Signature) d. DATE (YYYYMMDD)

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:

4. DISBURSING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

23rd FMSUAPO,AE 09098

b. DISBURSING OFFICER (Printed Name, Title and Signature)/S/

JAMES R. RICHARDSON, LTC, FC, CMD

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:555-5555

5. PERIOD: a. FROM: b. TO:

c. DISBURSING STATION SYMBOL NUMBER

6348d. DATE (YYYYMMDD)

20131201

6. DATE RECEIVED 7. NAME OF REMITTER

DESCRIPTION OF REMITTANCE8. DETAILED DESCRIPTION OF

PURPOSE FOR WHICHCOLLECTIONS WERE RECEIVED

9. AMOUNT 10. ACCOUNTING CLASSIFICATION

1Dec13 SPC Earl Martin710th MSB APO, AE 09098555-86-9453

SDP Deposit ECC# 397465

$2,365.00 21X201011D11A76VV76VV0065 7000.10K7 74983QLOG 5879364000000

ECC

11. TOTAL $2,365.00

DD FORM 1131, DEC 2003 PREVIOUS EDITION IS OBSOLETE.

Page 11: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

CASH COLLECTION VOUCHER

1. DISBURSING OFFICE COLLECTION VOUCHER NUMBER473159

2. RECEIVING OFFICE COLLECTION VOUCHER NUMBER

3. RECEIVING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

b. RECEIVED AND FORWARDED BY (Printed Name, Title and Signature) d. DATE (YYYYMMDD)

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:

4. DISBURSING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

23rd FMSUAPO,AE 09098

b. DISBURSING OFFICER (Printed Name, Title and Signature)/S/

JAMES R. RICHARDSON, LTC, FC, CMD

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:555-5555

5. PERIOD: a. FROM: b. TO:

c. DISBURSING STATION SYMBOL NUMBER6348

d. DATE (YYYYMMDD) 20131201

6. DATE RECEIVED 7. NAME OF REMITTER

DESCRIPTION OF REMITTANCE8. DETAILED DESCRIPTION OF

PURPOSE FOR WHICH 9. AMOUNT COLLECTIONS WERE RECEIVED

10. ACCOUNTING CLASSIFICATION

1Dec13 GySgt George Blackmon 2-10th INF BNAPO, AE 09098555-28-4169

SDP Deposit Check # 75

$3,700.00 21X201011D11A76VV76VV0065 7000.10K7 74983QLOG 6798421000000

PC

11. TOTAL $3,700.00

DD FORM 1131, D E C 2003 PREVIOUS EDITION IS OBSOLETE.

Page 12: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

CASH COLLECTION VOUCHER

1. DISBURSING OFFICE COLLECTION VOUCHER NUMBER473160

2. RECEIVING OFFICE COLLECTION VOUCHER NUMBER

3. RECEIVING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

b. RECEIVED AND FORWARDED BY (Printed Name, Title and Signature) d. DATE (YYYYMMDD)

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:

4. DISBURSING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

23rd FMSUAPO,AE 09098

b. DISBURSING OFFICER (Printed Name, Title and Signature)/S/

JAMES R. RICHARDSON, LTC, FC, CMD

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:555-5555

5. PERIOD: a. FROM: b. TO:

c. DISBURSING STATION SYMBOL NUMBER6348

d. DATE (YYYYMMDD) 20131201

6. DATE RECEIVED 7. NAME OF REMITTER

DESCRIPTION OF REMITTANCE8. DETAILED DESCRIPTION OF

PURPOSE FOR WHICH 9. AMOUNT COLLECTIONS WERE RECEIVED

10. ACCOUNTING CLASSIFICATION

1Dec13 LCpl Freida Dewese 97th MI BNAPO, AE 09098555-64-7943

SDP Deposit Check # 147

$1,500.00 21X201011D11A76VV76VV0065 7000.10K7 74983QLOG 8136479000000

PC

11. TOTAL $1,500.00

DD FORM 1131, D E C 2003 PREVIOUS EDITION IS OBSOLETE.

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CASH COLLECTION VOUCHER

1. DISBURSING OFFICE COLLECTION VOUCHER NUMBER473161

2. RECEIVING OFFICE COLLECTION VOUCHER NUMBER

3. RECEIVING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

b. RECEIVED AND FORWARDED BY (Printed Name, Title and Signature) d. DATE (YYYYMMDD)

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:

4. DISBURSING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

23rd FMSUAPO,AE 09098

b. DISBURSING OFFICER (Printed Name, Title and Signature)/S/

JAMES R. RICHARDSON, LTC, FC, CMD

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:555-5555

5. PERIOD: a. FROM: b. TO:

c. DISBURSING STATION SYMBOL NUMBER

6348d. DATE (YYYYMMDD)

20131201

6. DATE RECEIVED 7. NAME OF REMITTER

DESCRIPTION OF REMITTANCE8. DETAILED DESCRIPTION OF

PURPOSE FOR WHICHCOLLECTIONS WERE RECEIVED

9. AMOUNT 10. ACCOUNTING CLASSIFICATION

1Dec13 PFC Blair Sweeney1-12 FA BNAPO, AE 09098555-28-5793

SDP Deposit Check # 202

$1,000.00 21X201011D11A76VV76VV0065 7000.10K7 74983QLOG 6579812000000

PC

11. TOTAL $1,000.00

DD FORM 1131, DEC 2003 PREVIOUS EDITION IS OBSOLETE.

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CASH COLLECTION VOUCHER

1. DISBURSING OFFICE COLLECTION VOUCHER NUMBER473162

2. RECEIVING OFFICE COLLECTION VOUCHER NUMBER

3. RECEIVING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

b. RECEIVED AND FORWARDED BY (Printed Name, Title and Signature) d. DATE (YYYYMMDD)

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:

4. DISBURSING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

23rd FMSUAPO,AE 09098

b. DISBURSING OFFICER (Printed Name, Title and Signature)/S/

JAMES R. RICHARDSON, LTC, FC, CMD

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:555-5555

5. PERIOD: a. FROM: b. TO:

c. DISBURSING STATION SYMBOL NUMBER

6348d. DATE (YYYYMMDD)

20131201

6. DATE RECEIVED 7. NAME OF REMITTER

DESCRIPTION OF REMITTANCE8. DETAILED DESCRIPTION OF

PURPOSE FOR WHICH 9. AMOUNT COLLECTIONS WERE RECEIVED

10. ACCOUNTING CLASSIFICATION

1Dec13 SPC Quincy Scales95th MP BN APO, AE 09098555-58-1379

GPLDCheck # 22

205.33 213202011D11A76VV76VV0065 5000.10K7 796541KNAQ 479863200000

PC

11. TOTAL 205.33

DD FORM 1131, D E C 2003 PREVIOUS EDITION IS OBSOLETE.

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CASH COLLECTION VOUCHER

1. DISBURSING OFFICE COLLECTION VOUCHER NUMBER473163

2. RECEIVING OFFICE COLLECTION VOUCHER NUMBER

3. RECEIVING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

b. RECEIVED AND FORWARDED BY (Printed Name, Title and Signature) d. DATE (YYYYMMDD)

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:

4. DISBURSING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

23rd FMSUAPO,AE 09098

b. DISBURSING OFFICER (Printed Name, Title and Signature)/S/

JAMES R. RICHARDSON, LTC, FC, CMD

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:555-5555

5. PERIOD: a. FROM: b. TO:

c. DISBURSING STATION SYMBOL NUMBER

6348d. DATE (YYYYMMDD)

20131201

6. DATE RECEIVED 7. NAME OF REMITTER

DESCRIPTION OF REMITTANCE8. DETAILED DESCRIPTION OF

PURPOSE FOR WHICH 9. AMOUNT COLLECTIONS WERE RECEIVED

10. ACCOUNTING CLASSIFICATION

1Dec13 CPT Walter Moore 96th CABAPO, AE 09098555-35-2874

Overpayment of Entitlements Check # 334

2,294.97 213202011D11A76VV76VV0065 3000.12R4 421976BAPT 5691202000000

PC

11. TOTAL 2,294.97

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DD FORM 1131, D E C 2003 PREVIOUS EDITION IS OBSOLETE.

Page 17: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

CASH COLLECTION VOUCHER

1. DISBURSING OFFICE COLLECTION VOUCHER NUMBER473164

2. RECEIVING OFFICE COLLECTION VOUCHER NUMBER

3. RECEIVING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

b. RECEIVED AND FORWARDED BY (Printed Name, Title and Signature) d. DATE (YYYYMMDD)

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:

4. DISBURSING OFFICEa. ACTIVITY (Name and Location) (Include ZIP Code)

23rd FMSUAPO,AE 09098

b. DISBURSING OFFICER (Printed Name, Title and Signature)/S/

JAMES R. RICHARDSON, LTC, FC, CMD

c. TELEPHONE NUMBER (Include Area Code):COMMERCIAL: DSN:555-5555

5. PERIOD: a. FROM: b. TO:

c. DISBURSING STATION SYMBOL NUMBER

6348d. DATE (YYYYMMDD)

20131201

6. DATE RECEIVED 7. NAME OF REMITTER

DESCRIPTION OF REMITTANCE8. DETAILED DESCRIPTION OF

PURPOSE FOR WHICHCOLLECTIONS WERE RECEIVED

9. AMOUNT 10. ACCOUNTING CLASSIFICATION

1Dec13 PO1 Heather Cole45th CASH APO, AE 09098555-69-7318

SDP Deposit ECC # 497836

$2,550.00 21X201011D11A76VV76VV0065 7000.10K7 74983QLOG 7894236000000

ECC

11. TOTAL $2,550.00

DD FORM 1131, D E C 2003 PREVIOUS EDITION IS OBSOLETE.

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DD FORM 1351-6, JUN 93 Replaces DD Forms 115 (MAY 74), 1351-1 (SEP 61), and 1351-6(NOV 64), which may be used until DEC 31, 1993.

MULTIPLE PAYMENTS LIST Page 1 of 1 Pages

PRIVACY ACT STATEMENT

AUTHORITY: Title 5 USC 5516, 5517, 5520, and 5701; Title 37 USC 404-427; and E.O. 9397

PRINCIPAL PURPOSE(S): Used to supplement DD Form 1351-2, "Travel Voucher or Subvoucher," to substantiate claims for reimbursement when multiple individuals of an organization are performing official travel at the same time, between the same points, and accounting data is the same. The information co l lec ted may also be used as a payroll list.

ROUTINE USE(S): Information may be furnished to an employee's state and/or local taxing authorities, to comply with agreements entered into by the Secretary of the Treasury, for verification of filing information used by an individual in a tax return; in addition, release of information on this form may be made to Federal, state, local or foreign law enforcement agencies, for investigation of and possible prosecution of an individual charged with violating any law, statute, rule, regulation, or order in this claim for restitution.

DISCLOSURE: Voluntary; however, failure to furnish requested information may result in total or partial denial of amount claimed.

1. TYPE OF PAYMENT (Check applicable) D.O. VOUCHER NUMBER

248239MILITARY PAY (MP) TRAVEL ALLOWANCE (TA) X OTHER (Specify) Local Pay PAID BY

23rd FMSU APO AE 09098DSSN: 6348

2. PAYROLL NUMBER (If applicable)Active Duty Enlisted

3. DATE OF COMPUTED PAYMENT20131201

4. ORGANIZATION AND STATION

5. PAYEE IDENTIFICATION

a. LAST b. FIRST c. MI d. SSN

e. TRAVEL ORDER OR OTHER AUTHORITY

f. AMOUNT g. SIGNATUREOR CHECK NUMBER

1 Jones John 555-01-1234 300.00 /S/ 12 Henderson David 555-02-8976 250.00 /S/ 23 Frederick Nathan 555-03-6321 200.00 /S/ 34 Lewis Ann 555-40-5487 260.00 /S/ 45 Robinson Lisa 555-65-5897 175.00 /S/ 56 Jackson Vernon 555-32-4215 230.00 /S/ 67 Davis Patricia 555-54-8963 225.00 /S/ 78 Utley Neil 555-87-4631 80.00 /S/ 89 Lawson Katy 555-89-4745 140.00 /S/ 9

10 Sampson Gerald 555-56-8973 120.00 /S/ 1011 Moore Henry 555-01-4879 100.00 /S/ 1112 Anderson James 555-53-8946 150.00 /S/ 1213 O'Neil Mary 555-78-5278 100.00 /S/ 1314 Patterson Frank 555-64-4389 150.00 /S/ 1415 Robertson Terry 555-86-4521 250.00 /S/ 1516 Harris Neil 555-72-4618 300.00 /S/ 1617 O'Connor Sean 555-63-4786 250.00 /S/ 1718 Perry Nick 555-48-7634 275.00 /S/ 1819 Brown Mark 555-46-2194 160.00 /S/ 1920 Cooper Lori 555-52-9421 300.00 /S/ 2021 Meyers Karen 555-73-1793 220.00 /S/ 2122 Woods Marcus 555-65-4784 240.00 /S/ 2223 Franks Lionel 555-34-7964 300.00 /S/ 2324 Newton Heidi 555-42-8976 250.00 /S/ 24

PAGE TOTAL 5025.006. ACCOUNTING CLASSIFICATION213201011D13 A76VV76VV0065 7000.10K7 132097QLOG 15493670000000 $5025.00 CA1

7. PURSUANT TO AUTHORITY VESTED IN ME, I CERTIFY THESE STATEMENTS ARE CORRECT AND PROPER

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DD FORM 1351-6, JUN 93 Replaces DD Forms 115 (MAY 74), 1351-1 (SEP 61), and 1351-6(NOV 64), which may be used until DEC 31, 1993.

a. NAME AND TITLE OF CERTIFYING OFFICER (Please type)

SSG James Johnson, Certifying Officer

b. CERTIFYING OFFICER (Signature)

/S/

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X

DD FORM 1351-6, JUN 93 Replaces DD Forms 115 (MAY 74), 1351-1 (SEP 61), and 1351-6(NOV 64), which may be used until DEC 31, 1993.

MULTIPLE PAYMENTS LIST Page 1 of 1 Pages

PRIVACY ACT STATEMENT

AUTHORITY: Title 5 USC 5516, 5 5 1 7 , 5 5 2 0 , a n d 5701; T i t l e 37 USC 404-427; and E.O.

9397

PRINCIPAL PURPOSE(S): Used to supplement DD Form 1351-2, "Travel Voucher or Subvoucher," to substantiate claims for reimbursement when multiple individuals of an organization are performing official travel at the same time, between the same points, and accounting data is the same. The information co l lec ted may also be used as a payroll list.

ROUTINE USE(S): Information may be furnished to an employee's state and/or local taxing authorities, to comply with agreements entered into by the Secretary of the Treasury, for verification of filing information used by an individual in a tax return; in addition, release of information on this form may be made to Federal, state, local or foreign law enforcement agencies, for investigation of and possible prosecution of an individual charged with violating any law, statute, rule, regulation, or order in this claim for restitution.

DISCLOSURE: Voluntary; however, failure to furnish requested information may result in total or partial denial of amount claimed.

1. TYPE OF PAYMENT (Check applicable) D.O. VOUCHER NUMBER

248240MILITARY PAY (MP) TRAVEL ALLOWANCE (TA) OTHER (Specify) Local Pay PAID BY2. PAYROLL NUMBER (If applicable) USMC Officer

4. ORGANIZATION AND STATION

3. DATE OF COMPUTED PAYMENT 20131101

23rd FMSU APO AE 09098DSSN: 6348

5. PAYEE IDENTIFICATION

a. LAST b. FIRST c. MI d. SSN

e. TRAVEL ORDER OR OTHER AUTHORITY

f. AMOUNT g. SIGNATUREOR CHECK NUMBER

1 Berry Matthew 555-47-6857 275.00 /S/ 12 Klein Anthony 555-67-8156 160.00 /S/ 23 Jasper Nathan 555-57-8614 240.00 /S/ 34 Hunt Wendy 555-94-6378 130.00 /S/ 45 Flowers Brandon 555-42-3591 235.00 /S/ 56 O’Malley Sheila 555-83-1296 165.00 /S/ 67 Anderson Brian 555-45-1264 150.00 /S/ 78 Carpenter David 555-78-4614 175.00 /S/ 89 Utley Chase 555-43-7356 180.00 /S/ 9

10 McDaniel Mark 555-89-2896 165.00 /S/ 1011 Holden Tiffany 555-23-0912 110.00 /S/ 1112 Franks Regina 555-20-4901 225.00 /S/ 1213 1314 1415 Nothing Follows 1516 1617 1718 1819 1920 2021 2122 2223 CA1 2324 24

PAGE TOTAL 2210.006. ACCOUNTING CLASSIFICATION173201011D13 A76VV76VV0065 7000.10K8 132097QLOG 15493680000000 $2210

7. PURSUANT TO AUTHORITY VESTED IN ME, I CERTIFY THESE STATEMENTS ARE CORRECT AND PROPER

a. NAME AND TITLE OF CERTIFYING OFFICER (Please type)

SSG James Johnson, Certifying Officer

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DD FORM 1351-6, JUN 93 Replaces DD Forms 115 (MAY 74), 1351-1 (SEP 61), and 1351-6(NOV 64), which may be used until DEC 31, 1993.

b. CERTIFYING OFFICER (Signature)

/S/

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Previous edition usable NSN 7540-00-900-2234

USAPPC V1.00

PRIVACY ACT STATEMENTThe information requested on this form is required under the provisions of 31 U.S.C. 82b and 82c, for the purpose of disbursing Federal money. The information requested is to identify the particular creditor and the amounts to be paid. Failure to furnish this information will hinder discharge of the payment obligation.

Standard Form 1034Revised October 1987 Department of the Treasury 1 TFM 4-20001034-121

PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONALVOUCHER NO.

850671U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATIONDEPARTMENT OF THE ARMY23RD FMSUAPO AE 09808

DATE VOUCHER PREPARED12/01/2013

SCHEDULE NO.

CONTRACT NUMBER AND DATE PAID BY23RD FMSUAPO AE 09808ADSN 634812/01/13

REQUISITION NUMBER AND DATE

DATE INVOICE RECEIVED

DISCOUNT TERMS

PAYEE'S ACCOUNT NUMBER

WEIGHT GOVERNMENT B/L NUMBER

NUMBER AND DATE OF ORDERDATE OF DELIVERY OR SERVICEARTICLES OR SERVICES(Enter description, item number of contract or Federal supply schedule, and other information deemed necessary)

QUAN- TITYUNIT PRICE AMOUNT

COST PER (1 )

SC320112/01/13

12/01/13 DAMAGE TO LIVESTOCK

“FOR INSTRUCTIONAL PURPOSES ONLY”

3100.00

(Use continuation sheet(s) if necessary)(Payee must NOT use the space below)TOTAL 3100.00PAYMENT:PROVISIONAL COMPLETE PARTIAL FINAL PROGRESS ADVANCE

APPROVED FOR

=$ 3100.00EXCHANGE RATE=$1.00

BY 2 CA1

Amount verified; correct for 3100.00TITLE (Signature or initials)

Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment.

12/01/13/S/JAMES R. RICHARDSON, LTC, FC (Date)(Authorized Certifying Officer) 2(Title)

ACCOUNTING CLASSIFICATION

213201011D13 A76VV76VV0065 2000.15L9 692198ZFZW 69741250000000 3100.00

PA ID BY

CHECK NUMBER ON ACCOUNT OF U.S. TREASURY CHECK NUMBER ON (Name of bank)

CASH

$3100.00DATE

12/01/13PAYEE 3

/S/When stated in foreign currency, insert name of currency.If the ability to certify and authority to approve are combined in one person, one signature only is necessary; otherwise theapproving officer will sign in the space provided, over his official title.When a voucher is receipted in the name of a company or corporation, the name of the person writing the company orCorporate name, as well as the capacity in which he signs, must appear. For example: "John Doe Company, per John Smith, Secretary," or "Treasurer," as the case may be.

PER

TITLE

PAYEE'S NAME AND ADDRESS

Sayid ChoukranFOB Shank, AF

SHIPPED FROM TO

DIFFERENCES

Page 23: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

Standard Form 1034Revised October 1987 Department of the Treasury 1 TFM 4-20001034-121

PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONALVOUCHER NO.

850672U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATIONDEPARTMENT OF THE ARMY23RD FMSUAPO AE 09808

DATE VOUCHER PREPARED12/01/2013

SCHEDULE NO.

CONTRACT NUMBER AND DATE PAID BY23RD FMSUAPO AE 09808ADSN 634812/01/13

REQUISITION NUMBER AND DATE

DATE INVOICE RECEIVED

DISCOUNT TERMS

PAYEE'S ACCOUNT NUMBER

WEIGHT GOVERNMENT B/L NUMBER

NUMBER AND DATE OF ORDERDATE OF DELIVERY OR SERVICEARTICLES OR SERVICES(Enter description, item number of contract or Federal supply schedule, and other information deemed necessary)

QUAN- TITYUNIT PRICE AMOUNT

COST PER (1 )

OH320112/01/13

12/01/13 DAMAGE TO HOME

“FOR INSTRUCTIONAL PURPOSES ONLY”

2270.00

(Use continuation sheet(s) if necessary)(Payee must NOT use the space below)TOTAL 2270.00PAYMENT:PROVISIONAL COMPLETE PARTIAL FINAL PROGRESS ADVANCE

APPROVED FOR

=$ 2270.00EXCHANGE RATE=$1.00

BY 2 CA1

Amount verified; correct for 2270.00TITLE (Signature or initials)

Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment.

12/01/13/S/JAMES R. RICHARDSON, LTC, FC (Date)(Authorized Certifying Officer) 2(Title)

ACCOUNTING CLASSIFICATION

213201011D13 A76VV76VV0065 2000.17R4 687541ZWQA 69741250000000 2270.00

PA ID BY

CHECK NUMBER ON ACCOUNT OF U.S. TREASURY CHECK NUMBER ON (Name of bank)

CASH

$2270.00DATE

12/01/13PAYEE 3

/S/When stated in foreign currency, insert name of currency.If the ability to certify and authority to approve are combined in one person, one signature only is necessary; otherwise theapproving officer will sign in the space provided, over his official title.When a voucher is receipted in the name of a company or corporation, the name of the person writing the company orcorporate name, as well as the capacity in which he signs, must appear. For example: "John Doe Company, per John Smith, Secretary," or "Treasurer," as the case may be.

PER

TITLE

PAYEE'S NAME AND ADDRESS

Oshura HakmedFOB Shank, AF

SHIPPED FROM TO

DIFFERENCES

Previous edition usable NSN 7540-00-900-2234

USAPPC V1.00

PRIVACY ACT STATEMENTThe information requested on this form is required under the provisions of 31 U.S.C. 82b and 82c, for the purpose of disbursing Federal money. The information requested is to identify the particular creditor and the amounts to be paid. Failure to furnish this information will hinder discharge of the payment obligation.

Page 24: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

Standard Form 1034Revised October 1987 Department of the Treasury 1 TFM 4-20001034-121

PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONALVOUCHER NO.

850673U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATIONDEPARTMENT OF THE ARMY23RD FMSUAPO AE 09808

DATE VOUCHER PREPARED12/01/2013

SCHEDULE NO.

CONTRACT NUMBER AND DATE PAID BY23RD FMSUAPO AE 09808ADSN 634812/01/13

REQUISITION NUMBER AND DATE

DATE INVOICE RECEIVED

DISCOUNT TERMS

PAYEE'S ACCOUNT NUMBER

WEIGHT GOVERNMENT B/L NUMBER

NUMBER AND DATE OF ORDERDATE OF DELIVERY OR SERVICEARTICLES OR SERVICES(Enter description, item number of contract or Federal supply schedule, and other information deemed necessary)

QUAN- TITYUNIT PRICE AMOUNT

COST PER (1 )

KA130912/01/13

12/01/13 DAMAGE TO VEHICLE

“FOR INSTRUCTIONAL PURPOSES ONLY”

2685.00

(Use continuation sheet(s) if necessary)(Payee must NOT use the space below)TOTAL 2685.00PAYMENT:PROVISIONAL COMPLETE PARTIAL FINAL PROGRESS ADVANCE

APPROVED FOR

=$ 2685.00EXCHANGE RATE=$1.00

BY 2 CA1

Amount verified; correct for 2685.00TITLE (Signature or initials)

Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment.

12/01/13/S/JAMES R. RICHARDSON, LTC, FC (Date)(Authorized Certifying Officer) 2(Title)

ACCOUNTING CLASSIFICATION

213201011D13 A76VV76VV0065 2000.19W2 516931CVAP 69741250000000 2685.00

PA ID BY

CHECK NUMBER ON ACCOUNT OF U.S. TREASURY CHECK NUMBER ON (Name of bank)

CASH

$2685.00DATE

12/01/13PAYEE 3

/S/When stated in foreign currency, insert name of currency.If the ability to certify and authority to approve are combined in one person, one signature only is necessary; otherwise theapproving officer will sign in the space provided, over his official title.When a voucher is receipted in the name of a company or corporation, the name of the person writing the company orcorporate name, as well as the capacity in which he signs, must appear. For example: "John Doe Company, per John Smith, Secretary," or "Treasurer," as the case may be.

PER

TITLE

PAYEE'S NAME AND ADDRESS

Kareem Al'HarekFOB Shank, AF

SHIPPED FROM TO

DIFFERENCES

Previous edition usable NSN 7540-00-900-2234

USAPPC V1.00

PRIVACY ACT STATEMENTThe information requested on this form is required under the provisions of 31 U.S.C. 82b and 82c, for the purpose of disbursing Federal money. The information requested is to identify the particular creditor and the amounts to be paid. Failure to furnish this information will hinder discharge of the payment obligation.

Page 25: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

Standard Form 1034Revised October 1987 Department of the Treasury 1 TFM 4-20001034-121

PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONALVOUCHER NO.

850674U.S. DEPARTMENT, BUREAU, OR ESTABLISHMENT AND LOCATIONDEPARTMENT OF THE ARMY23RD FMSUAPO AE 09808

DATE VOUCHER PREPARED12/01/2013

SCHEDULE NO.

CONTRACT NUMBER AND DATE PAID BY23RD FMSUAPO AE 09808ADSN 634812/01/13

REQUISITION NUMBER AND DATE

DATE INVOICE RECEIVED

DISCOUNT TERMS

PAYEE'S ACCOUNT NUMBER

WEIGHT GOVERNMENT B/L NUMBER

NUMBER AND DATE OF ORDERDATE OF DELIVERY OR SERVICEARTICLES OR SERVICES(Enter description, item number of contract or Federal supply schedule, and other information deemed necessary)

QUAN- TITYUNIT PRICE AMOUNT

COST PER (1 )

FY478312/01/13

12/01/13 CRANE REPAIR

“FOR INSTRUCTIONAL PURPOSES ONLY”

1110.00

(Use continuation sheet(s) if necessary)(Payee must NOT use the space below)TOTAL 1110.00PAYMENT:PROVISIONAL COMPLETE PARTIAL FINAL PROGRESS ADVANCE

APPROVED FOR

=$ 1110.00EXCHANGE RATE=$1.00

BY 2 CA1

Amount verified; correct for 1110.00TITLE (Signature or initials)

Pursuant to authority vested in me, I certify that this voucher is correct and proper for payment.

12/01/13/S/JAMES R. RICHARDSON, LTC, FC (Date)(Authorized Certifying Officer) 2(Title)

ACCOUNTING CLASSIFICATION

213201011D13 A76VV76VV0065 2000.19W2 516931CVAP 69741250000000 1110.00

PA ID BY

CHECK NUMBER ON ACCOUNT OF U.S. TREASURY CHECK NUMBER ON (Name of bank)

CASH

$1110.00DATE

12/01/13PAYEE 3

/S/When stated in foreign currency, insert name of currency.If the ability to certify and authority to approve are combined in one person, one signature only is necessary; otherwise theapproving officer will sign in the space provided, over his official title.When a voucher is receipted in the name of a company or corporation, the name of the person writing the company orcorporate name, as well as the capacity in which he signs, must appear. For example: "John Doe Company, per John Smith, Secretary," or "Treasurer," as the case may be.

PER

TITLE

PAYEE'S NAME AND ADDRESS

Farrek YakmedFOB Shank, AF

SHIPPED FROM TO

DIFFERENCES

Previous edition usable NSN 7540-00-900-2234

USAPPC V1.00

PRIVACY ACT STATEMENTThe information requested on this form is required under the provisions of 31 U.S.C. 82b and 82c, for the purpose of disbursing Federal money. The information requested is to identify the particular creditor and the amounts to be paid. Failure to furnish this information will hinder discharge of the payment obligation.

Page 26: Identify Daily Accountable Transactions · Web viewFailure to furnish this information will hinder discharge of the payment obligation. DD FORM 1351-6, JUN 93Replaces DD Forms 115

1. DISBURSING OFFICER DESIGNATIONYour Name

2. RATES OF EXCHANGE (Number of Foreign Currency Units to one U.S. Dollar)

3 FC to 1 US Dollar

3. DATE 20131201 4. DSSN: 6348

5. NAME OF CASHIER OR DEPUTY: Cashier #1

6. RECEIVED FROM CUSTOMER 7. DISBURSED TO CUSTOMER 8. NAME AND OTHER INFORMATION REQUIRED BY DISBURSING OFFICER ON PERSON FOR WHOM EXCHANGE IS MADE

a. TYPE OF NEGOTIABLE INSTRUMENT

RECEIVED(Personal check,

etc.)

b. U.S. CURRENCY AND COIN

c.FOREIGN CURRENC

Y

d. TOTAL a. U.S. CURRENCY AND COIN

b.

FOREIGN CURRENC

Y

c.

Eagle Cash Card

d.

TOTA

L

200.00 200.00 200.00 200.00 PFC Jones /S/EC 234856 150.00 150.00 450.00 150.00 CPT Kingston /S/

200.00 200.00 200.00 200.00 2LT Evans /S/PC#37 150.00 150.00 EC150.00 150.00 SSG Lowe /S/EC 127845 165.00 165.00 165.00 165.00 SPC Halstead /S/PC #33 150.00 150.00 150.00 150.00 MAJ Waters /S/EC 325693 85.00 85.00 255.00 255.00 SGT Calhoun /S/

225.00 225.00 EC 225.00 225.00 CW3 Anderson /S/PC#56 300.00 300.00 900.00 300.00 SFC Snow /S/

175.00 175.00 175.00 175.00 A1C Dent /S/300.00 300.00 EC 300.00 300.00 LCpl Nieves /S/

EC 312654 275.00 275.00 275.00 275.00 LTC Matthews /S/PC#87 165.00 165.00 EC 165.00 165.00 GySgt Brown /S/

75.00 225.00 150.00 EC 150.00 150.00 TSgt Eamon /S/180.00 60.00 EC 60.00 60.00 1LT Ingles /S/

Total 2,615.00 405.00 2,750.00 965.00 535.00 1250.00 2750.00

DD Form 2664

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Eagle Cash Card Sales ReceiptDecember 1, 2013

Card Number Amount 11111011279843 $275.0011111011479813 $85.0011111011397465 $2,365.0011111011379846 $150.0011111011169778 $165.0011111011497836 $2,550.0011111011997456 $175.00

Grand TotalsSales 7 $5,765.00

Please Keep For Your records

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SVC Card ProcessingLoad Transaction Detail Report - All Types

12/01/2013 to 12/01/2013

Card Number Transaction 11111011400247 $150.0011111011587104 $300.0011111011973645 $225.0011111011357984 $165.0011111011287469 $200.0011111011149873 $60.0011111011698743 $150.00

Total Transactions 7 $1,250.00

Average Transaction Amount $178.57

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Batch List

Batch: (WBA187AB-0448-4S2F-88GE-0662A7217002)Date: 12/01/2013 5:20PM

Printed By: Cashier #1

S T IRN Capture Time Bank No. Acct. No. Check No. Amount User Defined FieldsA P 1100000723 4:50:00 PM 111222333 123456999 113 $3,000.00 555-11-2222A P 1100000722 4:35:00 PM 222666777 123456888 87 $165.00 555-22-3333A P 1100000721 3:23:00 PM 999444555 987456111 334 $2,294.97 555-44-7777A P 1100000720 2:46:00 PM 888000666 654123777 147 $1,500.00 555-99-6666A P 1100000719 2:13:00 PM 777111888 541239666 33 $150.00 555-88-7777A P 1100000718 1:56:00 PM 333888000 741852663 56 $300.00 555-66-9999A P 1100000717 1:32:00 PM 666444222 258963741 22 $205.33 555-77-2222A P 1100000716 1:06:00 PM 111222888 159753456 37 $150.00 555-55-6666A P 1100000715 11:43:00 AM 777000444 951753258 68 $542.33 123-45-6789A P 1100000714 10:34:00 AM 222444777 486315468 75 $3,700.00 123-98-7654A P 1100000713 9:23:00 AM 101133374 751953846 83 $200.00 123-47-8965A P 1100000712 9:14:00 AM 624486111 217896543 202 $1,000.00 123-86-4397

Sub Total: Count: 12 Amount: $13,207.63OTC Endpoint Total Count: 12 Amount: $13,207.63

Grand Total: Count: 12 Amount: $13,207.63