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ATTACHMENT VII

Sample of CO-19, Batch Header

new 11/88 OFFICE OF THE STATE TREASURER
(1) BATCH DATE (2) BATCH NUMBER (3) AGENCY NUMBER (4) AGENCY TELEPHONF, NO/CONTACT PERSON (5) PAGE
OF
(6) BATCH TOTAL (7) DEPOSIT DATE (PER FUND MANAGER) (8) TOTAL DEPOSITED (PER FUND MANAGER)
(9) (10) (11) (12) (13) (14) (15)
AGENCY BOND FUND PAYEE PROJECT NAME PROJECT NUMBER DEPOSIT AMOUNT EXPENDITURE PROJECT TOTAL ACT
N/F
(16) PAGE TOTAL
CORRECTIONS
CERTIFICATION AGENCY TREASURY

DISTRIBUTION: PART 1 - TREASURER PART 2 - AGENCY

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