SIGN OFF

TENANT: ________________________________
CENTER:                                                                
EXAMINATION SITE:                                           
EXAMINATION DATE:                                         

PLACE OF EXAMINATION           CHECK ONE                                                 
c STORE    c CORPORATE     c ACCOUNTANT c CORRESPONDENCE

                1. List of documentation supplied to examiner for review (circle all that apply):
. a.        Daily cash register tapes
b.       Bank statements/deposit slips
c.        Sales journals/General ledger
d.       Sales tax returns
e.        Financial statements
f.         Federal income tax returns
g.       Annual certification of reported gross sales
h.       Any other relevant information
                2.  I have been shown the examinerís workpapers, copies and schedules.
                3.  I do agree that the figures shown to me were correctly copied to schedules and the figures accurately reflect the journal, ledger or report they were taken from.
                4.  The examiner requested to review the following documents, records or reports which were not provided
  a.                                                                e.                                                            
  b.                                                             f.                                                             
  c.                                                             g.                                                            
  d.                                                             h.                                                            
                5. 

Date examiner will receive documentation referenced above:                      

                6. 

The reason the documents, record and/or reports were not provided is due to:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

                7. 

Tenantís comments:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

                8. 

I have initialed all statements not in my own handwriting to show I have reviewed statements and these statements are accurate, and have signed and dated this document.
 

SIGNED                                      PRINT NAME                                    
TITLE                                         PHONE NUMBER                              
DATE                                     

 

Opinion Summary of Gross Sales Monthly Gross Sales Percentage Rent Schedule
Examiner's Comments Examiner's Recommendations Other Findings Sign Off
       
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