Agency No. and Name: GASB No. and Name: STATEMENT OF CASH FLOWS CHECKLIST -- PART 1 REVIEWED BY/ date: APPROVED BY / date:
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1 SECTION I Lines 1-14 must be reviewed in conjunction with SECTION II below 1 Receipts from customers Worksheet 1 (Section A or B) "Total to Cash Flow Statement" column 2 Receipts from other funds Worksheet 1 (Section A) "Total to Cash Flow Statement" column 3 Not used 4 Receipts from federal agencies (exchange activity only) Worksheet 1(Sections C) "Total to Cash Flow Statement" column 5 Collections of loans to students and employees Worksheet 1 (Section D, X) "Total to Cash Flow Statement" column 6 Payments for salaries and benefits to employees Worksheet 1 (Section E) "Total to Cash Flow Statement" column 7 Payments for prizes, benefits and claims Worksheet 1 (Section F) "Total to Cash Flow Statement" column 8 Payments to vendors and suppliers Worksheet 1 (Section G) "Total to Cash Flow Statement" column 9 Payments to other funds Worksheet 1 (Section G) "Total to Cash Flow Statement" column 10 Payments for scholarships and fellowships (univ & colleges) Worksheet 1 (Section I) "Total to Cash Flow Statement" column 11 Payments for loans issued to students and employees Worksheet 1 (Section J) "Total to Cash Flow Statement" column 12 Other receipts (Operating or nonoperating) Worksheet 1and/or 2 (Section H1 & AE1) 13 Other payments - describe Description on the cash flow statement (Section H2 & AE2) 14 Net cash provided (used) by operating activities The sum of lines 1 through 13. Must agree to line a State appropriations Agency identified - should tie to operating statement 15b State aid-general (for use by component units only) Agency identified - should tie to operating statement 15c State aid-program [For component units only-if deferred state aid was received (deferred inflow of resources) - include here] Agency identified - should tie to operating statement 16 State Aid for Higher Education Lottery only (Worksheet 2 Section AH) 17 Gifts (noncapital) Worksheet 2 (Section AC) 18 Noncapital Grant receipts Worksheet 2 ( Section AB) 18a Fed Recovery Funds (receipts of ARRA funds) Worksheet 2 ( Section ABa) 19a Proceeds short-term borrowing Worksheet 2 (Section AJ) 19b Principal payments short-term borrowing Worksheet 2 (Section AJ) CASHFLO.XLS Page 1
2 20a Advances from Fed Unemployment Acct Worksheet 2 (Section AK) 20b Payments to Fed Unemployment Acct Worksheet 2 (Section AK) 20c Advances from other funds added FY2015-for use by DOT-Turnpike/any other fund w/ advance 21 Interest expense and other costs Worksheet 2 (Section AD) 22 Bond issuance costs Worksheet 2 (Section AE2) Worksheet 2 (827-Section AH) 22.5 Grants, aid and subsidies (nonoperating expense) Used by DENR for nonop subsidies to other gov'ts for clean water 23 Transfers in from other funds Worksheet 2 (Section AF) 24 Transfers out to other funds Worksheet 2 (Section AG) 25 Insurance recoveries Worksheet 2 (Section AA) 26 Extraordinary items 27 Special items 28 Other noncap financing receipts-describe Worksheet 2 (Section AE1) --- generally will be non-operating item 29 Other agency identified noncapital financing payments Worksheet 2 (Section AE2) --- generally will be non-operating item 30 Net cash provided (used) by noncapital financing activities The sum of lines 15 through Acquisition and construction of capital assets Worksheet 2 (Section Q) 32 Proceeds from the sale of capital assets Worksheet 2 (Section Q) 33 Proceeds from capital debt Worksheet 2 (Sections T,U) 34 Not used 35 State capital appropriations 36 Federal interest subsidy on Debt (new for 2010) Worksheet 2 (Section AI) 37 Capital grants (nonoperating grants for capital use) Worksheet 2 (Sections AB) 38 Capital gifts (nonoperating capital gifts and donations) Worksheet 2 (Sections AC,) 39 Transfers from other funds Worksheet 2 (Sections AF) 40 Not Used Currently 41 Principal payments on capital debt and leases Worksheet 2 (Sections T,U,V) 42 Interest payments on capital debt and leases Worksheet 2 (Sections Y,AD) 43 Payment to bond escrow agent CASHFLO.XLS Page 2
3 44 Bond issuance costs Worksheet 2 (Section AE2) 45 Insurance recoveries Worksheet 2 (Section AA) 46 Extraordinary items 47 Special items 48 Other receipts [Misc nonoper items that fit here] Worksheet 2 (Section AE) 49 Other agency identified capital financing payments Description on the cash flow statement Net cash provided (used) by capital 50 and related financing activities The sum of lines 31 through Proceeds from sale of non-state Treasurer investments Worksheet 2 (Section K) 52 Redemptions from State Treasurer Long-Term Invest. Pool Worksheet 2 (Section L) 53 Interest on investments Worksheet 2 (Sections W, Z) 54 Purchase of non-state Treasurer investments Worksheet 2 (Section K) 55 Purchases of State Treasurer Long-Term Invest. Pool Worksheet 2 (Section L) 56 Other receipts [Misc nonoper items that fit here] 57 Other agency identified investment activity payments Description on the cash flow statement 57a,b,c, for EPA-Revolving Loan specifically Worksheet 2 (Section N) 58 Net cash provided (used) by investing activities The sum of lines 51 through 57c. Net increase(decrease) in total cash (cash and cash 59 equivalents, pooled cash and restricted cash) The sum of lines 14, 30, 50, and Cash, Cash Equivalents, Pooled Cash July 1 All cash accounts per CAFR 11P (see line 66 below) 61 Cash, Cash Equivalents, Pooled Cash June 30 All cash accounts per CAFR 11P (see line 66 below) 62 Cash and Cash Equivalents, current and noncurrent Per CAFR 11P (see line 66 below) 63 Pooled Cash, current and noncurrent Per CAFR 11P (see line 66 below) 64 Restricted cash, current and noncurrent Per CAFR 11P (see line 66 below) 65 Other agency identified cash reconciliation items Must be fully identified on the Statement of Cash Flows 66 Total cash per statement of cash flows Lines 62,63,64,65 of the statement-(must include all cash accounts) 67 Operating Income (Loss) Operating Income (Loss) -- CAFR 53P 68a Depreciation expense Depreciation -- CAFR 53P 68b Pension expense (NCAS acct ) Worksheet 1 (811) - [Section E] new for FY15 CASHFLO.XLS Page 3
4 69 Investment Earnings Investment Earnings-- CAFR 53P 70 Mortgage/Loan/Note Principal Repayments Worksheet 2 (Section O) 71 Loan Sales Worksheet 2 (Section O) 72 Mortgages/Loans/Notes Issued Worksheet 2 (Section O) 73 Mortgage/Loan/Note Cancellation and Write-offs Worksheet 2 (Section O) 74 Allowances and Uncollectible Accounts Identified by Agency or Bad Debt per section A Worksheet 1 75 Nonoperating Mortgage/Loan/Note Interest Income Worksheet 2 (Section Z) 76 Other adjustments to operating income Full description must be on the cash flow statement 77 to 101 Changes in Assets, Deferred outflows and Liabilities See part 2 for a separate analysis of changes in assets and liabilities. ***Use Comp 11P for DSS agencies for checklist Part Total Cash Provided From (Used For) Operations The sum of lines 67 through 101. Must agree to line to116 Noncash Investing, Capital, and Financing This section should agree to the Wsheet 2 references (page ) SECTION II REVIEW OF WORKSHEETS 1 AND 3 A on Worksheet 1--Columns foot B C D on Worksheet 1--for each section, the total of each " Worksheet 3 Distribution" column carries to and is equal to the related box in "Total to Cash Flow Statement" column on Worksheet 1--Captions on this worksheet that show internal and external distributions per the " Worksheet 3 Distribution" columns are also identified and described on Worksheet 3 on Worksheet 1--Box in "Total to Cash Flow Statement" column must have proper sign ( receipts are plus, payments are minus) E on Worksheet 3--captions described on this worksheet actually have amounts on Worksheet 1 F on Worksheet 3--Internal plus external allocations equal 100% and have an explanation G on Worksheet 3--Internal and external distributions that show activity on this worksheet are coming from internal or external columns that have activity on Worksheet 1 (and vice versa). CASHFLO.XLS Page 4
5 (May 2015) AGENCY NAME & No. GASB Name & No.: STATEMENT OF CASH FLOWS CHECKLIST -- PART 2 REVIEWED BY: APPROVED / date: CHANGES IN ASSETS, DEFERRED OUTFLOWS AND LIABILITIES For DSS agencies, use Comp 11P report and/or the new DSS Condensed Comp 11P Worksheet for Cash Flows which combines current and noncurrent amounts. Print and attach for the review of these lines. This Part 2 checklist can be used for offline agencies or Bal Sheet Bal Sheet Line if comments are needed for NCAS agencies. Current Yr Prior Yr # Current and noncurrent amounts should be combined. AMOUNT AMOUNT CHANGE COMMENTS 77 (Increase) Decrease in Accounts Receivable 78 (Increase) Decrease in Intergovernmental Receivables 79 (Increase) Decrease in Investment Earnings Receivable (NOTE 1) 80 (Increase) Decrease in Premiums Receivable 81 (Increase) Decrease in Contributions Receivable 81a (Increase) Decrease in Other receivables 82 (Increase) Decrease in Due from Other Funds 83 (Increase) Decrease in Due from Component Units 84 (Increase) Decrease in Due from Primary Government 85 (Increase) Decrease in Inventories 86 (Increase) Decrease in Prepaid Items (NOTE 2) 87 (Increase) Decrease in Other Assets new line starting FY (Increase) Decrease in Deferred outflows for pensions Employer contributions to TSERS this year 89 Increase (Decrease) in Accounts Payable (NOTE 3) 90 Increase (Decrease) in Accrued Payroll 91 Increase (Decrease) in Intergovernmental Payables 92 Increase (Decrease) in Due to Other Funds CSHFLPT2.XLS Page 1
6 (May 2015) AGENCY NAME & No. GASB Name & No.: STATEMENT OF CASH FLOWS CHECKLIST -- PART 2 REVIEWED BY: APPROVED / date: CHANGES IN ASSETS, DEFERRED OUTFLOWS AND LIABILITIES For DSS agencies, use Comp 11P report and/or the new DSS Condensed Comp 11P Worksheet for Cash Flows which combines current and noncurrent amounts. Print and attach for the review of these lines. This Part 2 checklist can be used for offline agencies or Bal Sheet Bal Sheet Line if comments are needed for NCAS agencies. Current Yr Prior Yr # Current and noncurrent amounts should be combined. AMOUNT AMOUNT CHANGE COMMENTS 93 Increase (Decrease) in Due to Component Units 94 Increase (Decrease) in Due to Primary Government 95 Increase (Decrease) in Obligations/ rev. repo. Agreements 96 Increase (Decrease) in Claims Payable 97 Increase (Decrease) in Deposits Payable 98 Increase (Decrease) in Funds Held for Others 99 Increase (Decrease) in Comp absences (Accrued vac leave) 100 Increase (Decrease) in Notes Payable 101 Increase (Decrease) in Unearned Revenue NOTE 1: Only if interest is an operating revenue. NOTE 2: Only if the prepaid item was originally charged against an operating expense NOTE 3: Amounts could be affected by noncash accruals. see worksheet 2 section R CSHFLPT2.XLS Page 2
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