Provide accurate branch and employee identification details for audit trail purposes. All fields marked mandatory must be completed before submission.
Branch Code
Branch Name
Branch Full Address
Reporting Date
Shift End Time
Employee ID Number
Employee Full Legal Name
Job Role/Position
Teller
Senior Teller
Head Teller
Vault Custodian
Assistant Branch Manager
Branch Manager
Acting Manager
Shift Type
Morning (06:00-14:00)
Afternoon (14:00-22:00)
Evening (22:00-06:00)
Full Day
Split Shift
Cash Drawer/Vault Identifier
Immediate Supervisor Name
Supervisor Employee ID
Was a proper handover completed from previous shift?
Provide handover confirmation details and any noted discrepancies from previous shift:
Explain why proper handover was not completed and what alternative verification was performed:
Has this specific drawer/vault location experienced variances in the past 30 days?
How many variance incidents in the past 30 days?
Document the exact variance amount and provide a complete breakdown by denomination. Calculate variance percentage relative to total drawer/vault balance. All currency values must be entered with standard decimal notation.
Variance Type Classification
Shortage (Actual < Expected)
Overage (Actual > Expected)
Balanced (No Variance)
Total Variance Amount
Is the variance within the institution's acceptable threshold limit?
Institutional Threshold Limit Amount
Variance as Percentage of Expected Balance (%)
Total Expected Balance per System/Log
Total Actual Counted Balance
Denomination Breakdown - Bills
Denomination | Expected Count | Actual Count | Variance Count | Value per Unit | Total Variance Value | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | 100 | 500 | 498 | -2 | $100.00 | -$200.00 | |
2 | 50 | 800 | 800 | 0 | $50.00 | $0.00 | |
3 | 20 | 1200 | 1195 | -5 | $20.00 | -$100.00 | |
4 | 10 | 600 | 610 | 10 | $10.00 | $100.00 | |
5 | 5 | 400 | 398 | -2 | $5.00 | -$10.00 | |
6 | 1 | 500 | 505 | 5 | $1.00 | $5.00 | |
7 | 0 | $0.00 | |||||
8 | 0 | $0.00 | |||||
9 | 0 | $0.00 | |||||
10 | 0 | $0.00 |
Denomination Breakdown - Coins
Coin Type | Expected Count | Actual Count | Variance Count | Value per Unit | Total Variance Value | ||
|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | ||
1 | 1.00 | 200 | 200 | 0 | $1.00 | $0.00 | |
2 | 0.50 | 150 | 148 | -2 | $0.50 | -$1.00 | |
3 | 0.25 | 300 | 304 | 4 | $0.25 | $1.00 | |
4 | 0.10 | 250 | 250 | 0 | $0.10 | $0.00 | |
5 | 0.05 | 200 | 195 | -5 | $0.05 | -$0.25 | |
6 | 0 | $0.00 | |||||
7 | 0 | $0.00 | |||||
8 | 0 | $0.00 | |||||
9 | 0 | $0.00 | |||||
10 | 0 | $0.00 |
Does this variance involve foreign currency or non-standard denominations?
Specify foreign currency types, denominations, and conversion rates applied:
Total Transaction Volume Processed During Shift
Total Number of Transactions Processed
Peak Hour Transaction Count (Highest 60-min period)
Document all audit and reconciliation procedures performed to identify root cause. Include timestamps, personnel involved, and outcomes of each step. Follow-up questions will appear based on your responses.
Was an immediate physical recount performed?
Recount performed by (Employee Name & ID):
Explain why immediate recount was not performed and what alternative verification was used:
Was a witness present during the recount/audit process?
Witness Employee Name:
Justify why no witness was present and what compensating controls were implemented:
Was system-level reconciliation attempted using core banking platform?
Describe system reconciliation steps and any discrepancies found in transaction logs:
Explain barriers to system reconciliation and manual workarounds performed:
Which manual audit procedures were completed? (Select all that apply)
Transaction log printout reviewed
Cash-in/cash-out tickets verified
ATM settlement reconciliation
Teller assist device audit
Previous day carry-forward verification
Endorsement verification
Cash transfer logs checked
Vault access logs cross-referenced
None of the above
Were any system errors or technical issues encountered during the shift?
Describe technical issues, error codes, and impact on cash handling:
Were any cash handling equipment malfunctions identified (e.g., bill counter, coin sorter)?
Detail equipment malfunction, serial number, and service request number:
What is the current reconciliation status?
Fully Reconciled - Root cause identified
Partially Reconciled - Some questions remain
Unreconciled - Root cause unknown
Pending External Review
Under Investigation
Does this variance require escalation beyond branch level?
Escalation Level Required:
Regional Manager
Area Director
Internal Audit Department
Loss Prevention Unit
Executive Management
Regulatory Reporting
Timestamp when variance was first discovered
Time duration spent on initial investigation (hh:mm)
Detailed chronological log of all audit steps performed, including timestamps and responsible personnel:
Record all security-related investigations including camera footage review, transaction monitoring, and any suspicious activity identification. This section is critical for fraud detection and loss prevention.
Has security camera footage been reviewed for the shift period?
Footage Review Completion Status:
Fully Reviewed - All relevant cameras
Partially Reviewed - Sample of cameras
In Progress - Review ongoing
Scheduled - Review planned within 24h
Unable to Review - Technical issues
Explain why footage has not been reviewed and when review will occur:
List specific camera IDs and timestamps reviewed (e.g., CAM-04: 14:30-15:45):
Total number of security cameras reviewed
Were customer-facing cash transactions reviewed in detail?
Number of high-risk customer transactions reviewed
Were high-value transactions (above institutional threshold) specifically reviewed?
High-value transaction threshold amount used:
Was any suspicious behavior or potential fraud indicators observed?
Describe suspicious behavior, involved parties, and timestamp details:
Were any procedural violations by staff identified?
Select all procedural violations observed:
Dual control not followed
Cash drawer left unattended
Incorrect login/logout procedures
Unauthorized vault access
Failure to verify customer identity
Improper endorsement handling
Late transaction reporting
Override without proper authorization
Other
Are there indicators of potential external theft or robbery attempt?
Describe external theft indicators and immediate actions taken:
Has all relevant evidence been preserved and secured?
Explain what evidence is missing and why:
Evidence storage location/reference number
Has law enforcement or internal security been notified?
Incident Report Number/Case ID:
Security Officer on Duty (Name & ID)
Overall Security Risk Rating for this incident (1=Low Risk, 5=Critical Risk)
Final review and compliance verification by branch management. Ensure all required approvals, notifications, and corrective action plans are documented before final submission.
Has the Branch Manager reviewed and verified all reconciliation findings?
Explain why Branch Manager review is pending and expected completion date:
Branch Manager Full Name
Branch Manager Employee ID
Has the Regional/Area Manager been notified of this variance?
Regional Manager Name:
Justify why Regional Manager has not been notified:
Has the institutional compliance checklist been completed for this incident?
List pending compliance items and remediation plan:
Compliance Items Verified (Select all that apply):
Regulatory reporting requirements checked
Insurance notification completed
Internal audit notified
Loss prevention guidelines followed
Documentation retention policy applied
Employee conduct review initiated
Customer impact assessment completed
Data privacy protocols maintained
Are corrective actions required to prevent recurrence?
Detail corrective action plan, responsible parties, and implementation timeline:
Is additional training or coaching required for involved personnel?
Training Topics Required:
Cash handling procedures
Dual control protocols
System operation
Fraud detection
Customer verification
Emergency procedures
Documentation standards
Security awareness
Branch Manager Digital Signature - Verifying accuracy of reported information
Branch Manager Sign-Off Timestamp
Does this incident require Internal Audit Department review?
Internal Auditor Assigned:
Final Resolution Status
Open - Under Investigation
Resolved - Root cause addressed
Closed - No further action required
Pending - Awaiting external input
Referred - Escalated to specialized unit
Estimated Final Resolution Date
Final Documentation Storage Location/Reference
Additional Comments, Observations, or Recommendations:
Attach supporting documents (e.g., transaction logs, recount sheets, system screenshots)
To configure an element, select it on the form.