[See rule 13 (i)]
OFFICE OF.......................................................................................... MONTH OF......................................................
| Particulars | Contingencies | |||||||||
| Date | No. of the receipt issued or bill drawn | From whom received | Cheque/ DD No. or Serial Nos. in the register of valuables | Receipt to be credited to Govt. account | Salaries and advances | In recoupment of permanent advance | Advance payment | Miscellaneous | Total | Classification |
| Rs. P. | Rs. P. | Rs. P. | Rs. P. | Rs. P. | Rs. P. | |||||
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| Contingencies | |||||||||
| Date | Sub-vouchers Nos. /Sr. No.(s) in the register of valuables | To whom paid or sent to P.A.O./ Bank for crediting | Receipts to be credited to Govt. account | Salaries and advances | Out of permanent advance | Out of money drawn in anticipation of payments | Miscellaneous | Total | Classification |
| Rs. P. | Rs. P. | Rs .P. | Rs. P. | Rs. P. | Rs. P. | ||||
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Foot Note (to be printed as flyleaf):
(1) Form of Certificates to be recorded under rule 13 (iv) - "Certified that the cash balance has been physically verified by me today (date...........................) and found to be Rs .............................................................................. (Rupees .......................................................................................... which tallies with the closing balance as worked out in the cash book".
(2) Self cheques drawn under cheque drawing powers, for payments to staff etc., in cash, should also be entered on the receipts side of the cash book.
(3) Closing balance should be analysed in the following manner:—
| Rs. P. | ||
| (i) | Cash | |
| (ii) | Self Cheques Not transferable category of cheques and bank drafts. |
|
| (iii) | Other cheques | |
| (iv) | Other Bank drafts | |
| (v) |
Imprest with (a) .......................................... |
|
| (vi) | ................................................ | |
| Total cash balance [Items (i) to (vi)]. |