Standard LGC 203 (Rev. 6-16), page 1
IMPORTANT - Please read the form reminders tab and sample 203 for assistance.
AS OF
JUNE 30
LGC Use Only
Name of Unit:
Unit Code Unit Type
Legal Name of Unit:
CERTIFICATION
Telephone Number, includi ng are a code
This is to certify that the Name of Official (Type or print your name) Unit Mai li ng Address - Str eet Number Extension
data contained in this
report is accurate to the
Title (i.e. Finance Officer, Treasurer, etc) Unit Mai li ng Address - Ci ty, State & Zip Code
best of my knowledge
and belief.
Signature of Official (only if mailing or faxing)
I.
Cash on hand
(see Instruction 2).
Amount
Pe tty cash funds and change funds ……………………………………………
Undepo sited receipts ……………………………………………
Total Cas h on Hand
Manual Pre parers: ENTER TOTAL CASH ON PAGE 2 S ECTION VI LIN
II.
Pooling Me thod Financ ial Inst itutions
Manual Preparers: LIST ONLY BANKS INCLUDED ON POOLING BANK MEMO
Select Bank from Drop Down menu Demand Interest Bearing
Do not se le ct the same bank name more tha n one time
Deposits Chec king Acco unts
Enter total amount for each Account type at the bank goi ng across Regular Savings
C.D.s
(1)
(2)
(3)
(4)
(5)
---
Total Pooling Bank
$ $ $ $
Grand Total Pooling D
Grand Totals for All Poo ling Banks $ $ $ $
Manual Pre parers: ENTER GRAND TOTAL ON PAGE 2 SECTION VI L
III.
De dicated Met hod Financial Institution
(see Instruction 3 & 5): Note: All Housi ng Authorities mus t use the De dicated Met hod rules.
Manual Preparers: fill out Section VII on Pg.2 for each Dedicated Bank
A B C
List the Bank Name and location Demand Time Interest Bearing
Do not ent er the same bank name more t han once
Deposits Deposits Chec king Acco unts
Enter total amount for each Account type at the bank going across Regular Savings C.D.s
(1)
(2)
(As required by G.S. 159-33 and G.S. 115C-446)
LOCAL GOVERNMENT COMMISSION
3200 Atlantic Avenue, Raleigh, North Carolina 27604
REPORT OF DEPOSITS AND INVESTMENTS
FINISTAR (total pooling amount from statement) attach
statement or leave blank if NA
Supplemental Pages - TOTALS (Pooling Method)
Handout#3
Standard LGC 203 (Rev. 6-16), Page 2
V. Investments (see Instruction 7): Se nd your own suppleme ntal re port that includes details and market value totals for each type belo w.*(se nd wit h LGC-203 )
INVESTMENT TOTALS Name of Custodian
or Safekeeper
Type of Security Purchase Amount Total * Market Value Total
Government Securities
$
Government Agencies
$
Bankers' Acceptance
$
Other Investments
$
Repurchase Agreements (see Instruction 8):
$
Grand Total of Sect. V Investments (See Instruction 9)
VI.
Summary
(s ee Ins truction 1 1)
:
Please recheck totals.
(1) Cash on hand (ENTER TOTAL FROM PAGE 1 SECTION I)
$
(2) Total cash on deposit for Pooling Method (from SECTION II)
$
(3) Total cash on deposit for Dedicated Method (from SECTION III)
$
(4) Total cash (Lines 1, 2 & 3 totaled)
(5) Investments - Pg. 1 (totals Sec tion IV)
(6) Investments - Pg. 2 (totals Sec tion V)
(7) Total cash and investments (total lines 4, 5 & 6 combined)
(8) Less: Unexpended bond and/or note proceeds
(9) Net cash and investments (line 7 minus 8)
Deposits in Dedicated Method Financial Institutions:
(See Instruction 12)
REQUIRED for banks lis
Name of financial institution (1)
(a) (b) (a)-(b)
Deposit FDIC Insured Uninsured
Amount
Amount Amount
Total Demand deposits: Sec. III. - A …………………………………………..
$
250,000$
$ U.S. Treas. & agencies
Time deposits: regular savings & CD's combined: Sec. III. B …………………………
$
NOW, SUPERNOW, and Money Market
Interest Bearing checking accounts: Sec. III. C ……………………………………
Totals agree to Supplementary Pages or suppplemental
report provided by Unit
State of N.C.
/county/municipal
REPORT OF DEPOSITS AND INVESTMENTS