Monthly Reconciliation Statement Real Estate …

1 _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ (When using this form as a supplement to the Monthly Reconciliation Statement real Estate Trust Account, clearly indicate on the face of the Monthly Reconciliation Statement real Estate Trust Account form the number of addenda used in Monthly Reconciliation Statement real Estate Trust Account Addendum FLORIDA ASSOCIATION OF REALTORS supplementing the Monthly Reconciliation Statement real Estate Trust Account.)

2 Addendum No. _____ 1. The following information supplements the Monthly Reconciliation Statement prepared by (Print Broker s Name) for the month of _____, _____. Date used for Reconciliation : _____ / _____ / _____. (month and day) (year) (Name of Bank) (Name of Account, Account number) Bank Statement period _____ / _____ / _____ through _____ / _____ / _____. 2. Adjusted Account Balance Supplement to paragraph 2 of the Monthly Reconciliation Statement . Outstanding Checks Deposits Not Credited Date Check # Amount Date Amount _____ _____ $_____ _____ $_____ Total Outstanding Checks $_____ Total Deposits Not Credited $_____ (per Addendum No. _____) (per Addendum No. _____) Include total Outstanding Checks from this addendum in the Outstanding Checks total reported in paragraph 2 of the Monthly Reconciliation Statement .

3 Include total Deposits Not Credited from this addendum in the deposits not credited total reported in paragraph 2 of the Monthly Reconciliation Statement . EQUAL HOUSINGREALTOR OPPORTUNITYMSRA-1 Rev. 4/98 1998 Florida Association of REALTORS All Rights Reserved _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ 3. Itemized List of Broker s Trust Liability Supplement to paragraph 3 of the Monthly Reconciliation Statement . Client/Transaction Name _____ _____ MSRA-1 Rev. 4/98 1998 Florida Association of REALTORS All Rights Reserved Reconciled Balance $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____ $_____$_____$_____ _____ 3.

4 Itemized List of Broker s Trust Liability Supplement to paragraph 3 of the Monthly Reconciliation Statement . (Continued) Client/Transaction Name Reconciled Balance _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ _____ $_____ Total of Broker s Trust Liability (per Addendum No. _____) $_____Include Total of Brokers Trust Liability from this Addendum in the Total Broker s Trust Liability reported in paragraph 3 of the Monthly Reconciliation Statement . 4. Signature I, _____, Broker, reviewed this Monthly Statement / Reconciliation on _____, _____. (month and day) (year) Broker s signature (required on all Reconciliation Statements) This form is available for use by the entire real Estate industry and is not intended to identify the user as a REALTOR.

5 REALTOR is a registered collective membership mark that may be used only by real Estate licensees who are members of the National Association of REALTORS and who subscribe to its Code of Ethics. The copyright laws of the United States (17 Code) forbid the unauthorized reproduction of blank forms by any means including facsimile or computerized forms. MSRA-1 Rev. 4/98 1998 Florida Association of REALTORS All Rights Reserved