Accounting Division. 
Form 5215. 
Approved by the Comptroller of the 
Treasury February 13, 1913. 
Ed. 25,000— F. C., Mar. 24-17. 
CD 
STATEMENT OF DISBURSING ACCOUNT. 
Treasury Department, 
Office of the Treasurer of the United States. 
Washington, D. C., 
mi*-' 
\t: 1 
Sir. The lonowing is a statement of your Disbursing Account for the month of 
Please reconcile your check- book balance at the close of the month with the balance shown 
peiow, taking* mto consideration outstanding checks and deposits in transit, and advise me 
without delay it any discrepancy in balance, check amounts, or numbers is found. 
Respectfully, / ~J$b*r***& 
ALEXANDER WET MO RE, 725 OO , 
T EM P . S * D . A • , Treasurer of the United States. 
C/0 A. ZAPPOME, 
DEPT . , AGR I CULTURE , 
WASHINGTON, D.C. 
Dr. 
Or. 
Total Checks Paid, as per Abstract below — 
U 0 4.4 4. 
Balance from last Statement 
1,7 0 4 4 4 / 
Balance __ . ... 
: 
Deposits Received, as per Abstract below - 
Total 
i 
1,7 0 4.44# 
• 
Total 
1,7 0 4.4 4 * 
/ 
Treasury Department, 
Office of the Treasurer of the United States, 
Accounting Division. 
Respectfully referred to the Auditor for the 
Department. 
Assistant Treasurer U. S. 
ABSTRACT OF CHECKS PAID. 
ABSTRACT OF DEPOSITS RECEIVED. 
DATE. 
NUMBER. 
AMOUNT. 
DATE 
CREDITED. 
DEPOSIT 
NUMBER. 
DEPOSITED 
WITH. 
AMOUNT. 
2 4 6 5.1 9 
5 2 2 3.0 9 
7 2 3 5.59 
6 19 3.68 
9 2 2 3.0 8 
3 0 2 4.3 4 
1 4 3 6.3 9 
2 11153 
3 13 9.07 
1,7 0 4.4 4 i 
1 921 MAR 
IA PR 
MAY 
