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<br />Supporting Documents Form <br /> <br />B. Inanclal Ca ablli <br /> <br />Th grantee should prepare financial statements at least annually. At a minimum, current Internal balance sheet and <br />In me statements are required. A balance sheet is a statement of financial position of a grantee disclosing the assets, <br />Iia i1nies, and retained earnings at a given point In time. An Income statement Is a summary of the revenue and expenses <br />of grantee for a specified period of time, usually for an accounting or fiscal year. <br /> <br /> <br />as an independent audit been conducted of <br />organization? If ves. provide a copy of the <br />t recent audit report. If!!l!. provide <br />les of the most recent Balance Sheet and <br />me Statement. <br /> <br />~ SELECT One: liiIl <br /> <br />,I Yes ." II <br />fI S~~CT One: i1 <br />II S~~:CT One: i <br /> <br />2. oes the organization prepare financial <br />sta ements at least annually? <br /> <br />3. ccording to the organization's most recent <br />Au it or Baiance Sheet, are the current total <br />as ets greater than the liabilities? <br /> <br />C. ud eta Controls <br /> <br />Th grantee should establish a system to track expenditures against budget and/or <br />fun ed amounts. <br /> <br />1. e there budgetary controls in effect (e.g., comparison of budget with actual <br />ex enditures on a monthly basis) to preclude drawing down grant funds in excess of: <br /> <br />a) otal funds authorized on the Statement of <br />Gr nt Award? <br /> <br />b) otal funds available for any budget category <br />as tipulated on the Statement of Grant Award? <br /> <br />l <br />~ SELECT One: ill <br />I Y~s , I ' <br /> <br />Ii SELE.CTon,e: il <br />I Yes, >...1 <br /> <br />If the answer is 'No', to any <br />question, explain the corrective <br />action that will be taken to ensure <br />accountabili . <br /> <br /> <br />If the answer is 'No', to any <br />question, explain the corrective <br />action that will be taken to ensure <br />accountability. <br /> <br />oj <br />I <br /> <br />D. nternal Controls <br /> <br />Th organization must safeguard cash receipts and disbursements and ensure a segregation of duties exists. For example. <br />on person should not have control over all aspects of the accounting system, such as signing checks and making <br />de osits. <br /> <br /> <br />1. as the organization instituted safeguards to ensure adequate controls regarding the <br />foil wing: <br /> <br />a) re accounting entries supported by <br />ap ropriate documentation (e.g., purchase <br />or rs, vouchers, receipts, invoices)? <br /> <br />fI S~~CT One: il <br /> <br />there separation of responsibility in the <br />ipt, payment, and recording of cash? <br /> <br />li SELECT One: j <br />I ,Yes::,: . ,I <br /> <br />Ot er: <br /> <br />Page 5 of5 <br /> <br />if the answer is 'No'. to any <br />question. explain the corrective <br />action that will be taken to ensure <br />accountability. <br /> <br />Supporling Documents Fonn <br />