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Iten #
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Item
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Information and Actions Taken
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1
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Date
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[## MON YEAR]
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2
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Security Cooperation Customer Code/IA/FMS Case Designator
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[XX-X-XXX]
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3
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Net Case Value
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[current value required to liquidate all obligations/expenditures]
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4
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Issue of Concern
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[be as descriptive as possible]
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5
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Documentation of Reconciliation Attempt
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[description of actions taken to demonstrate how the case has been reconciled among relevant systems (e.g. contracting, disbursing, etc.), date of reconciliation, corrective next steps (e.g. internal control implementation) etc. with documentation attached]
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6
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Total Out-of-Balance (if applicable)
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[$----, system (s) where reconciliation challenges are occurring]
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7
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System Adjustments required to balance case
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[provide description of adjustments]
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8
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Transaction documents are attached
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[Yes/no] [If documents are not attached, provide explanation]
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9
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IA point of contact (POC)
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[Name, email, phone number]
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