Fillable Custodial Account Deposit (Ohio Department of Administrative Services OIT SDD)

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Custodial Account Deposit (Ohio Department of Administrative Services OIT SDD)

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BROWSE OHIO DEPARTMENT OF ADMINISTRATIVE SERVICES OIT SDD (OH) FORMS

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Custodial Account Deposit
Agency
Name____________________________ Treasurer Remit No.______________ Date_______
Custodial Account Name___________________ Agency Remit No.___________________________
Custodial Account Number_________________ Agency No.________________________________
Cash
Description
Amount
Subtotal Cash:
Check#
Description
Amount
Subtotal Checks:
Wires
Description
Amount
Subtotal Wires:
Grand Total:
Authori
zed Signature_____________________________
Title___________________________________________
Please email using button above or fax to: (614) 485-6893.
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Custodial Account Deposit (Ohio Department of Administrative Services OIT SDD)

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Completed 21 July 2020

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