North Carolina State Bar REPORT DATE: _______________ 20____
Reconciliation Report ACCOUNT #: _______________________
Instructions
• Complete steps 2-7 monthly for each general trust, dedicated trust, and fiduciary account. Attach: 1) a copy of the
general ledger/checkbook register, 2) a list of outstanding deposits, 3) a list of outstanding checks, 4) the
corresponding bank statements and cancelled checks (or images thereof).
• Complete entire form at least quarterly for each general trust account. Attach: 1) items 1-4 above and 2) a list of
subsidiary ledgers
with corresponding balances.
Reconciliation of Lawyer’s Trust Account Records
1. Total of positive subsidiary ledger balances as of ________________ $________________________
(as of ending date shown on the corresponding bank statement)
Does any subsidiary ledger have a negative balance? □ Yes
□ No
2. General ledger/checkbook register balance as of _________________ $________________________
(as of ending date shown on the corresponding bank statement)
Bank Statement Reconciliation
3. Statement Ending Date _________________ and Balance $____________________
4. Plus: Outstanding deposits made to the account through end of month but
not reflected on bank statement
Number of outstanding deposits ________ Amount of outstanding deposits + ____________________
5. Minus: Outstanding disbursements made through end of month but not
reflected on bank statement
Number of outstanding disbursements _______ Amount of outstanding disbursements - _____________________
6. Adjusted Bank Balance $_____________________
7. The balance on line #6 □ agrees □ does not agree with the balances on lines #1 and #2. If the balances do not
agree, attach explanation and corrective action taken.
Report prepared by: _______________________________ ___________________________________
Print Name and Position Signature
Report prepared by a non-lawyer? □ Yes □ No If yes, does he/she have check signing authority for this trust account? □ Yes □ No
I certify that, for this account, I personally reviewed the above report, bank statement, and cancelled checks, and that all
discrepancies shall be investigated, identified, and resolved within ten days of this report.
Report reviewed by: _____________________________ _________________________________ ____________
Print Lawyer Name Signature Date
November 2019
