Sheet 1: Change Fund Reconciliation

	
	
	
	
	
	
	
	
	

		
RECONCILIATION FORM FOR CHANGE FUNDS
		
	

		


		


		


		


		


		


		


		


	
	

		


		
	

		


		


		


		


		


		


		


		
06.17.13
	
	

		
Date of cash count:
		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		
Name of person conducting count:
		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		
Name and Account Number of Fund:
		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		
Fiduciary:
		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		
Custodian:
		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		
Backup Custodian (if applicable):
		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		


		
Coin:
		
$ Total:
		
Grand Totals
		


		


	
	

		


		
Pennies
		


		


		


		


		


	
	

		


		
Nickels
		


		


		


		


		


	
	

		


		
Dimes
		


		


		


		


		


	
	

		


		
Quarter
		


		


		


		


		


	
	

		


		
Half-Dollars
		


		


		


		


		


	
	

		


		
Dollars
		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		


		


		


		


		
 $-   
		


		


	
	

		


		
Currency:
		
$ Total:
		


		


		


		


	
	

		


		
$1 Bills
		


		


		


		


		


	
	

		


		
$5 Bills
		


		


		


		


		


	
	

		


		
$10 Bills
		


		


		


		


		


	
	

		


		
$20 Bills
		


		


		


		


		


	
	

		


		
$50 Bills
		


		


		


		


		


	
	

		


		
$100 Bills
		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		


		


		


		


		
 $-   
		


		


	
	

		


		


		


		


		


		


		


		


	
	

		


		
Checks/Other
		


		


		


		


		


		


	
	

		


		
Description:
		
$ Total:
		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


	
	

		


		


		


		


		
 $-   
		


		


	
	

		


		


		


		


		


		


		


		


	
	

		


		
Total on Hand :
		
 $-   
		


		


		


		


	
	

		


		
Total Authorized Amount of Fund:
		


		


		


		


		


	
	

		


		
Total Over/(Short):
		
 $-