Fillable Printable Bank Reconciliation Statement Form

Bank Reconciliation Statement Form

S a m p l e

HK$

Record subsequent clearance of

reconciling Items

Balance per Cash Book: 123,456

Add:

Unpresented cheques

• Cheque No. 123393

400

Cheque presented on 2.2.2XX1

• Cheque No. 123394

2,000

Cheque presented on 3.2.2XX1

Credit Transfer

• Management Fees

1,000 3,400

Recorded in cash book on 5.2.2XX1

Less:

Bank Lodgement not shown on

Bank Statement

• Cheques deposited on 31.1. 2XX1

1,000

Dishonoured Cheque 1,000

Adjusted cash book on 3.2.2XX1.

Bank Charges 50

Handling fee for dishonoured

cheque. Recorded in cash book on

3.2.2XX1.

Autopay of electricity bill 20,000 22,050

Autopay effected on 31.1.2XX1.

Recorded in cash book on 3.2.2XX1

Balance per Bank Statement 104,806

Bank Reconciliation Statement

(as at 31.1.2XX1)

Prepared by : Approved by :

(name / title) (name / title)

(Note : The gures used in the above Bank Reconciliation Statement are for illustrative purpose only)

Example of Bank Reconciliation Statement

Bank: ABC Bank Account No. : Current Account 012-123456-001