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Reconciliation of Confidential Funds Report Statute 16.964 DOJ-134 (rev. 11/98)

Department of Justice RECONCILIATION OF CONFIDENTIAL FUNDS

FOR REPORT PERIOD:______

FEDERAL FUNDS

Beginning cash balance as of:______$

Confidential funds received from DOJ +

SUBTOTAL $

Confidential funds disbursed -

Ending cash balance as of:______$

STATE MATCH

Beginning cash balance as of:______$

Confidential funds received from DOJ +

SUBTOTAL $

Confidential funds disbursed -

Ending cash balance as of:______$

Grantee Name:______Grant #______

Prepared By:______Telephone Number:______

NOTE: The following information must be included with each reconciliation report:

* Nature of expenditure (P/S, P/E, P/I) and brief description. * Amount disbursed. * Assumed name of Informant Payee or Case Number (if Informant Payee not involved). * To what extent this expenditure contributed to the investigation.

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