ATDA SEMI-ANNUAL FINANCIAL STATEMENT

SYSTEM NAME___________________________

FOR THE PERIOD OF ____________ THRU____________

SUBMITTED BY_____________________, SYSTEM TREASURER

BEGINNING CASH ON HAND $________________

LESS TOTAL EXPENSES $________________

PLUS GROSS RECEIPTS $________________

+/- MISC __________________ $________________

=ENDING CASH ON HAND $________________

EXPENSE SUMMARY

OPERATING EXPENSES

BANK FEES $_______________

OFFICE SUPPLIES $_______________

POSTAGE/SHIPPING $_______________

PHONE/FAX/E-MAIL $_______________

OFFICER REIMBURSMENT

TRANSPORTATION $_______________

LODGING $_______________

MEALS $_______________

PAYROLL EXPENSES

GROSS WAGES $_______________

FEDERAL INCOME TAX $_______________

STATE AND CITY TAX $_______________

RRB T-1 $_______________

RRB T-2 $_______________

MED $_______________

OTHER EXPENSES

____________________ $_______________

____________________ $_______________

____________________ $_______________

____________________ $_______________

DISPATCHER DAILY RATE $_______________

OTHER DAILY PAY $_______________

PLEASE INCLUDE A CURRENT ROSTER EACH JANUARY