North Carolina State Bar REPORT DATE: _______________ 20_____
Monthly Trust Account Report Account Name: ______________________
Monthly Reconciliation and Review Account #: ______________________
Pursuant to Rules 1.15-3(d)(2) and 1.15-3(i)(1)
GENERAL INFORMATION
Complete one form for each general trust account
Attach the following: copy of general ledger/checkbook register, list of outstanding deposits, list of outstanding
checks, corresponding bank statement, cancelled checks or images thereof
Reconciliation of Lawyer’s Trust Account Records
1. General ledger/checkbook register balance as of last day of bank statement……………. $_____________________
(Attach copy of general ledger/checkbook register)
Bank Statement Reconciliation
2. Account Ending Balance as of ______________ (per attached bank statement)……… . $_____________________
Plus: Deposits in transit (deposits made to the account through end of month yet
not reflected on bank statement) ……………………………………………………………. +_____________________
Number of deposits in transit ………………………… ___________________
(attach list of outstanding deposits)
Less: Outstanding (uncleared) disbursements (disbursements made through end
of month not reflected in bank statement)………………………………………… -______________________
Number of outstanding disbursements………….. ___________________
(attach list of outstanding disbursements)
3. Adjusted Trust Account Bank Balance (as of end of report month)…………………….. $_____________________
4. The balance on line #3
□ agreed □did not agree with the balance reflected in line #1. If different, attach
explanation and corrective action.
Report prepared by a non-lawyer?
□Yes □No
If yes, does non-lawyer have trust account check signature authority? □Yes □No
Report prepared by: ____________________________ ______________________________ ________________
Name and position Signature Date
Lawyer Certification
I certify that I personally reviewed the above report, personally reviewed the monthly bank statement and cancelled
checks for each general trust account, dedicated trust account, and fiduciary account, and that all discrepancies shall be
investigated, identified, and resolved within ten days of this review.
___________________________ ___________________________ _____________ ______________________
Lawyer Name Signature Date Firm Name
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