DISBURSING OFFICE ATM CASH TRANSACTION LEDGER
1. TOTAL CASH DEPOSITS (+)
2. TOTAL CASH WITHDRAWALS (-)
3. DIFFERENCE ((+) to DO (-) from DO)
DD FORM 2671, SEP 2007
Adobe Professional 7.0
PREVIOUS EDITION IS OBSOLETE.
PRIVACY ACT STATEMENT
AUTHORITY: Executive Order 9397, Department of Defense Financial Management Regulation (DoDFMR) 7000.14-R, Vol. 5, Disbursing Policy and
Procedures, and 31 CFR 210.
PRINCIPAL PURPOSE(S): To account for deposits made to the designated Automatic Teller Machine (ATM) accountable officer for deposit into or
withdrawal from the ATM system.
ROUTINE USE(S): The information on this form may be disclosed as generally permitted under 5 U.S.C. Section 552a(b) of the Privacy Act of 1974,
as amended. It may also be disclosed outside of the Department of Defense to Federal, state, or local government agencies, which have identified a
need to know, for the purpose(s) identified in the DoD Blanket Routine Uses as published in the Federal Register.
DISCLOSURE: Voluntary; however, failure to furnish the requested information may prevent you from participating in the ATM system.
USER INSTRUCTIONS: When completing this form, the ATM Custodian MUST ensure that the personal information obtained from prior transactions
is covered and not viewable by unauthorized personnel.