YEAR-END REPORT NO. 4 STATEMENT OF REVENUE - 7956

(New: 03/2011)

At year-end, departments will prepare a final Statement of Revenue, Report No. 4.  The report presents a reconciliation of current year revenue recorded by the department with revenue recorded by the SCO as of June 30.

The final Statement of Revenue will show the balances of subsidiary revenue accounts after the revenue accruals have been posted.  See SAM section 8210.  Some examples are listed below:

  1. Adjustments for dishonored checks and cash shortages.
  2. Revenue items cleared during July representing cash received and earned on or before June 30.
  3. July apportionment of Surplus Money Investment Fund earnings.
  4. Accrual of interest earned on investments in securities.

A sample of Report No. 4, Statement of Revenue, is shown in the 7955 Illustration.

 

Agency Name and Number
STATEMENT OF REVENUE - REPORT NO.4
Fund Name and Number
For the period of July 1, 20___to June 30, 20__
As of 06/30/20XX
Revenue For General Fund
CODE NO. TITLE DETAIL TOTAL
0141200 Sale of documents 11,899.43
0142500 Misc Services to the Public 22,195.72
0161400 Miscellaneous Revenue 11,219.35
Total Revenue 45,314.50
RECONCILIATION OF STATE CONTROLLER'S REVENUE WITH STATEMENT OF REVENUE, JUNE 30, 20
DESCRIPTION DETAIL TOTAL
Total Revenue per State Controller's Office Accounts 45,091.73
Reconciling Factors:
Accruals per Report of Accruals 222.77
Adjustments to Controller's Accounts 0.00
Total Reconciling Factors 222.77
Total Revenue per Statement of Revenue 45,314.50
I certify (or declare) under penalty of perjury that the foregoing is true and correct and that
I have not violated any of the provisions of Article 4, Chapter 1, Division 4, Title 1,
Government Code (commencing with Section 1090).
Subscribed and executed this ___day of __ , 20__
at _____
California.

______________________

Signature of Officer

______________________

Type or print name of Officer

______________________

Title of Officer

1/ Current year revenue only. The amount should agree with the revenue accrual total on the Report of Accruals to Controller's Accounts, Report No. 1.
2/ This category should contain adjustments (other than year-end accruals) that have been recorded on the agency's books but have not been recorded on the books of the SCO. Example- A reimbursement that was erroneously recorded by the SCO as of revenue, has been corrected on the agency's books. The correcting entry had not been posted by the SCO as of June 30. The amount should agree with the adjustments on the Form 576B, Adjustments to Controller's Accounts, Report No. 3.


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