CITY OF SMITHVILLE, KANSAS



Bank Deposits Insurance Coverage

Month-End Documentation

Purpose. The purpose of this form is to document, usually at the end of each month, that all deposits at a bank are fully protected by FDIC insurance and pledged securities. This form should be completed for each bank the city has deposits in.

Bank Name______________________________________________________

Month-End Date__________________________________________________

FDIC Insurance _______________

Pledged Securities – Market Value (see attachment) _______________

Total Insurance + Pledged Securities _______________

Bank Account or CD Description Book Balance Bank Balance

____________________________ ________________ _ _______________

____________________________ _________________ _______________

____________________________ _________________ _______________

____________________________ _________________ _______________

____________________________ _________________ _______________

____________________________ _________________ _______________

____________________________ _________________ _______________

____________________________ _________________ _______________

____________________________ _________________ _______________

Total Deposits _______________

Excess Insurance and Pledged Securities

(Total Insurance + Pledged Securities – Total Deposits) _______________

Sources of Information for Book Balance (Carrying Amount) and Bank Balance: bank account reconciliations and CD statements from bank.

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