9.4 Bad Check Chargeback Notice, TR-11
FORM NAME: BAD CHECK CHARGEBACK NOTICE (TR-11)
INSTRUCTIONS FOR COMPLETION OF TR-11:
- REFERENCE NUMBER:
- This number is for agency reference purposes. The number should run
consecutively and be concurrent with each fiscal year.
- DATE: This is the date the list is prepared and sent to the Treasury.
- AGENCY NAME:
- Name of the agency preparing the form.
- AGENCY NUMBER:
- Number of the agency preparing the form.
- TELEPHONE #:
- Telephone number where contact person can be reached.
- AGENCY CONTACT:
- Please make sure the name is legible.
- BANK: Identify depository bank.
- ACCOUNT NO:
- Which account money was deposited to.
- FUND - SID - REVENUE OBJECT:
- Reflects what was originally used on the CO-39, Deposit Slip.
- If the deposit was a refund of payments to revenue object 9901/9909
the full coding is needed to process, which includes the expense object,
function, and activity. This information can be shown on the next detail line,
listed in the above order.
- The name of the company or individual that issued the check is needed
for audit purposes.
- The amount of the debit.
- INFORMATION TO VERIFY BEFORE PROCESSING:
- 1. That the amount on the check and the debit memo are the same.
- 2. That the check received belongs to your agency
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- 3. That the proper account has been charged.
If any of these discrepancies occur, please return the check
and debit memo, along with a note stating the problem, to the Treasury.
- DEBIT MEMO DATE:
- All bad checks processed should be listed by the date
- of the bank's debit memo and please attach a copy of
- each debit memo to the notice.
- Please include a subtotal for each fund and revenue object change,
along with a final total.
- An adding machine tape verifying the totals and the bank debit memos
should be sent with the bad check notice to the Treasury.
- If more than one page is used, each page should be numbered.
- If your agency deals with more than one bank - PLEASE - process
separate bad check notices for each bank.
- Deposits are made into the Treasurer's main depository account 0044 4407 at
Shawmut Bank. As the balance in this account is transferred each day to Shawmut
account 113 0477, the bank charges any bad check to account No. 113 0477.
- PLEASE SEND YOUR REPORTS AND DISCREPANCIES TO THE ADDRESS
LISTED ON THE TOP OF THE FORM, TR-11, TO THE ATTENTION OF:
CASH MANAGEMENT DIVISION.
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Bad Check Charge-back Notice
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