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<br />O"'B"O 10-11011'
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<br /> ,. F.d.'ol .I.,.n,y and O',an;lar,onol ~I."'.n'
<br /> REPORT OF FEOERAL CASH TRANSACTIONS
<br />,. No",. of G.an,..O'gan"a';." .. F.d..oIG."n,No. ".Oth., , G'""".', Account No. ..
<br /> I<lontl/y;o, No. Id.n"ly,ngNo.
<br /> n.,.,.o ..0....' .. L.."..of Cr.di'No. ,. L.uf>ay",,,n' Youch., No.
<br /> ,,,' ..." ".'0" .. Numb.. 01 poY"'""'Youch... 9. No..IT,.o'.'y o.och Rece,ved
<br />,. F.d..oIEMploy.rldon,;lico';onNo ". R.p.rrP.rlodIMo....h, D.y, Yn.)
<br /> FROM I I " I ,
<br />11. ~1 ATUS OF FEDO/AL C"'SH
<br /> .. Cash 00 hand beginning 01 ~lIod. ,
<br /> b. LellerofcledltwlllKlrawals ,
<br /> <. Treasurycl1cckpaymt'l1lS ,
<br /> d. Tolal receipts (Sumo! Lines band c). ,
<br /> .. ToLaI cash available (Sum of Lines a and a). ,
<br /> I. Glossdisbursemenl5. ,
<br /> ,. Federal share of program InC(JT1€ .. ,
<br /> h. Netdlsburscmenls (Line fminus Line g). ,
<br /> I. Ad)uSlmenlsot prior perioos ,
<br /> ,. Cashonhandendotpeliod ,
<br />". T),'o",ow",;n.,....11J.ap....n'.cooh'aqu;'a"'a"hfo"),aan.u,"a do,..
<br />". 01HE~ INFORMATION
<br /> . lntelestlnCaTle. ,
<br /> b. Advances tosubgranlees .. .
<br />... REMARKS (A"cc),oda;';ono!.),""...r"ac...o',)
<br />". CERTIFICATION _ I 'a,',f, .h., '0 ,I.. ba.' 01 m, ..~...Iao,. ""d bal.al'h;. "P.,"" "wa 'n .11 '.'PaC" .no .ho' 011 d,.b~"a",an.. ho.a boo" m.o.
<br /> ,.. 'h.p""....ondc.nd",.n.ol'".,..",.
<br />l'I.m. I'''. TELEPHONE
<br /> ""..Cod. 1'.".' I'.'
<br />~; gno,",..1 A~'~o'; l.d Oll.c.ol Dot. R.p." I. ~"bm",.d
<br /> eo, AGENCY USfONLY
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