BILLING RECEIVABLE SYSTEM
BATCH TRANSMITTAL FORM
ORIGINATING DEPT:
ORIGINATOR NAME:
BATCH DESCRIPTION:
TOTAL RECORD COUNT: NET RECORD DOLLARS: $
TOTAL DEBIT COUNT:
TOTAL DEBIT DOLLARS: $
TOTAL CREDIT COUNT:
TOTAL CREDIT DOLLARS: $
COMMENTS:
BATCH AUTHORIZED BY:
DATE
For Billing and Receivables Office Use Only
Date Received Batch ID:
Batch Count:
Batch Total:
Batch Date:
Batch Entered By: