State Form 14311 - Report Of Collections/receipts
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1REPORT OF COLLECTIONS / RECEIPTS
(Due Treasurer of State)
State Form 14311 (R / 7-89)
Approved by State Board of Accounts 1989.
FOR TREASURER USE ONLY
REF. NO.
LINE
FUND
DR / CR
ACCTG.
OBJECT
CENTER
AMOUNT
SUBTOTAL
$
DESCRIPTION
(Loans,
NO.
NO.
CODE
RULE
Rec., Inv.)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
GRAND TOTAL
I certify to the best of my knowledge and belief, the foregoing Report of Collections and Receipts due the
Currency
Treasurer of State includes:
Silver
1. Total money collected (including overages on unrecorded amounts) for the date indicated;
Checks
2. All amounts for prior periods not previously deposited with the Treasurer of State; less rev-
Deposits
enue on hand and in process and less
Wire Transfers
Lock Box
Debits
Name of Agency Official or Designee
Title
Credits
ACH
State Agency Name
Agency Number
TOTAL
TREASURER OF STATE
DISTRIBUTION:
White - Auditor of State;
Canary - Agency after processing;
Pink - Agency before processing
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