Fillable Printable Cash Receipts Journal Form
Fillable Printable Cash Receipts Journal Form
Cash Receipts Journal Form
DHHS CAC 5 (03/11)
Nutrition Services
RETAIN IN YOUR FILES. DO NOT MAIL TO STATE AGENCY.
North Carolina Department of Health and Human Services
Institution Name:
CHILD AND ADULT CARE FOOD PROGRAM
Institution Number:
CASH RECEIPTS AND DISBURSEMENTS JOURNAL
Claim Month/Year:
TRANSACTIONS / BANK ACCOUNT FUNDS AVAILABLE DURING THE MONTH APPLICATION OF FUNDS DURING THE MONTH
Operating Costs Other Operating Costs
Description Check # Deposits Expenditures
USDA Reimburse-ment
Other Income
Admin Labor
Other
Supplies Food Travel Equipment Other
BALANCE BROUGHT FORWARD
BALANCE CARRIED FORWARD
TOTAL (or SUB-TOTAL)
Administrative
Expenditures
D
a
t
e
Beginning Fund
Balance
Operating
Labor
Balance
Carried
Forward
