Filetype Excel XLSX | Posted on 09 Aug 2022 | 3 years ago
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218x Filetype XLSX File size 0.61 MB Source: files.nc.gov
Sheet 1: Instructions
| State of North Carolina | |||||||||||||
| Statewide Accounts Receivable Reporting Form | |||||||||||||
| Instructions | |||||||||||||
| Fiscal Year Ended June 30, 2021 | Fiscal Year: | 2021 | |||||||||||
| Agency Number: | |||||||||||||
| Agency Name: | Use AGENCY No. tab to lookup your agency's number | ||||||||||||
| Contact Person: | John/Jane Doe | ||||||||||||
| Contact Phone: | |||||||||||||
| Email Address: | |||||||||||||
| Instructions: | |||||||||||||
| State of North Carolina | GASB Fund Type: | All GASB Types in Total | ||||||||||||
| Statewide Accounts Receivable Reporting Form | Agency No.: | 0 | ||||||||||||
| Bad Debt Write-Offs | Agency Name: | Use AGENCY No. tab to lookup your agency's number | ||||||||||||
| Fiscal Year Ended June 30, 2021 | Preparer/Phone: | John/Jane Doe - | ||||||||||||
| Write-Off Activity During Fiscal 2021 | Taxes Receivable | Accounts Receivable | Intergovernmental Receivables | Notes/Loans Receivables | Interfund Receivables | Other Receivables | Total Receivables Write-offs |
|||||||
| Receivable Write-offs | $0.00 | |||||||||||||
| Contractual Adjustments | $0.00 | |||||||||||||
| Indigent Write-offs | $0.00 | |||||||||||||
| Total Write-offs for Fiscal Year 2020 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| State of North Carolina | GASB Fund Type: | All GASB Types in Total | ||||||||
| Statewide Accounts Receivable Reporting Form | Agency No.: | 0 | ||||||||
| Bad Debt Write-Off Analysis | Agency Name: | Use AGENCY No. tab to lookup your agency's number | ||||||||
| Fiscal Year Ended June 30, 2021 | Preparer/Phone: | John/Jane Doe - | ||||||||
| Note: If BOTH Variance is more than $1 million AND Variance % is more than 15, an explanation is required. | ||||||||||
| Write-Off Activity Type | 2021 | 2020 | Variance | Variance % | Explanation | |||||
| Taxes Receivable | ||||||||||
| Receivable Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Contractual Adjustments | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Indigent Care Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Total Taxes Receivable Write-Offs | $0.00 | $0.00 | $0.00 | $0.00 | 0% | |||||
| Accounts Receivable | ||||||||||
| Receivable Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Contractual Adjustments | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Indigent Care Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Total Accounts Receivable Write-Offs | $0.00 | $0.00 | $0.00 | $0.00 | 0% | |||||
| Intergovernmental Receivables | ||||||||||
| Receivable Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Contractual Adjustments | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Indigent Care Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Total Intergovernmental Receivables Write-Offs | $0.00 | $0.00 | $0.00 | $0.00 | 0% | |||||
| Notes / Loans Receivable | ||||||||||
| Receivable Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Contractual Adjustments | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Indigent Care Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Total Notes / Loans Receivable Write-Offs | $0.00 | $0.00 | $0.00 | $0.00 | 0% | |||||
| Interfund Receivables | ||||||||||
| Receivable Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Contractual Adjustments | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Indigent Care Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Total Interfund Receivables Write-Offs | $0.00 | $0.00 | $0.00 | $0.00 | 0% | |||||
| Other Receivables | ||||||||||
| Receivable Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Contractual Adjustments | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Indigent Care Write-Offs | $0.00 | $0.00 | $0.00 | 0% | ||||||
| Total Other Receivables Write-Offs | $0.00 | $0.00 | $0.00 | $0.00 | 0% | |||||
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