Seal

State of Florida
Department of Financial Services
Division of Treasury
Bureau of Funds Management

Quarterly Report of Agency Clearing and Revolving Funds
Chapter 17.58(4), Florida Statutes

Agency Name:
Address:
Quarter Ending :
   
Clearing Account
Revolving Account
Account
Name
Bank Name
and Address
Cash
Balance
Amount Dep.
into Treasury
Amount
Authorized
Cash
Balance
 
 
Totals

Division of Treasury
Bureau of Funds Management
Cash Management Section
200 East Gaines Street
Tallahassee, FL 32399-0344
Fax  (850) 413-2724


 

 
   
 


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