Form PROB48C "Request for Monthly Cash Flow Statement Financial Records"

What Is Form PROB48C?

This is a legal form that was released by the United States Courts on September 1, 2000 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2000;
  • The latest available edition released by the United States Courts;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form PROB48C by clicking the link below or browse more documents and templates provided by the United States Courts.

ADVERTISEMENT
ADVERTISEMENT

Download Form PROB48C "Request for Monthly Cash Flow Statement Financial Records"

Download PDF

Fill PDF online

Rate (4.4 / 5) 5 votes
OPROB 48C
Page 1 of 2
(9/00)
REQUEST FOR MONTHLY CASH FLOW STATEMENT FINANCIAL RECORDS
DEFENDANT’S FULL NAME
DOCKET NUMBER
All entries on the Cash Flow Statement must be accompanied by supporting documentation. Provide the probation officer with all records listed below
are applicable to your financial statements, along with your completed Cash Flow Statement by the close of
.
MONTHLY CASH INFLOWS
Allowances (housing, auto, travel)
Ë Copy of related pay stub, 1099 form for prior year, and possibly a letter
Salary/Wages
from the employer on company letterhead.
Ë Copy of all W-2 forms submitted with the prior year income tax return.
Gratuities/Tips
Copy of all pay stubs for the most recent one-month period.
Ë Copy of current month’s pay stubs, letter from employer estimating
Cash Advances
monthly gratuities earned, and W-2 form for the prior year.
Ë Copy of all pay stubs documenting cash advances.
Spouse (Significant Other’s) Salary/Wages
Cash Bonuses
Ë Copy of all W-2 forms submitted with the prior year income tax return.
Ë Copy of all pay stubs documenting cash bonuses, and copy of related
Copy of all pay stubs for the most recent one-month period.
1099 form.
Other Joint Spousal Income
Commissions
Ë Documentation verifying any monthly income jointly earned with the
Ë Copy of all 1099 forms submitted with the prior year income tax return.
spouse or significant other, (e.g., income from the spouse or significant
other or income from a business owned or controlled by the spouse or
significant other, that the defendant has a joint ownership interest in, or
Business Income
controls).
Ë Copy of the past six monthly financial statements of all businesses
owned or controlled by the defendant. Also, be sure to provide all
Income of Others in the Home
financial information requested in the “Assets” portion of the “Net
Ë Verification of the monthly earnings of all others living in the
Worth Statement” under “Section K, Business Holdings.”
defendant’s household (e.g., all pay stubs for the prior month, W-2
forms, and 1099 forms for the prior year), paid receipts or canceled
Interest/Dividends
checks for necessary monthly household expenditures (e.g., for food,
Ë Copy of most recent earnings statement from a financial institution (e.g.,
room rental, telephone, transportation, etc.) actually paid by this person
bank, brokerage firm, etc.). Copy of all 1099-INT forms, reporting
on behalf of the defendant.
annual interest earnings, for the past year.
Gifts From Family
Rental Income
Ë A signed and dated statement from the family member who gave gifts
Ë Copy of lease rental agreement, copy of monthly rental check received,
to the defendant during the month, listing the amounts, dates and
and copy of the deposit on the defendant’s monthly bank statement.
reasons given, and a copy of the check received, if any.
Trust Income
Gifts From Others
Ë Copy of the monthly trust income check, copy of the trust agreement,
Ë A signed and dated statement from the person(s) who gave gifts to
and a copy of the trust income tax return for the prior year.
the defendant during the month, listing the amounts, dates and
reasons given, and a copy of the check received, if any.
Alimony/Child Support
Loans From Your Business
Ë Copy of divorce decree, copy of payments received, and statements
Ë Copy of the past six monthly financial statements of all businesses
documenting child support/alimony obligations with payment history.
owned or controlled by the defendant that loaned money to the
defendant, including a detailed schedule of the “Loans To
Social Security
Shareholder/Owner” or “Due From Shareholder/Owner” general ledger
Ë Copy of most recent Social Security check and most recent benefits
accounts.
determination letter.
Mortgage Loans
Ë Copy of all mortgage checks received during the prior month, 1099
Other Government Benefits
forms submitted with the prior year tax return, and copy of the sales
Ë Copy of most recent government subsidy check (e.g., unemployment
agreement and escrow statement for all mortgage loans owed to the
compensation, or child support/alimony) and most recent benefits
defendant.
Other Loans
determination letter.
Ë Copy of loan documentation and copy of all loan checks received
Pensions/Annuities
during the prior month.
Ë Copy of pension/annuity check, copy of most recent pension plan
activity statement or annuity statement, and copy of pension plan or
Other (specify)
annuity contract.
Ë Documentation verifying the source of all other monthly cash inflows
(not yet disclosed or reported in these financial statements) and copy of
all related monthly checks received.
OPROB 48C
Page 1 of 2
(9/00)
REQUEST FOR MONTHLY CASH FLOW STATEMENT FINANCIAL RECORDS
DEFENDANT’S FULL NAME
DOCKET NUMBER
All entries on the Cash Flow Statement must be accompanied by supporting documentation. Provide the probation officer with all records listed below
are applicable to your financial statements, along with your completed Cash Flow Statement by the close of
.
MONTHLY CASH INFLOWS
Allowances (housing, auto, travel)
Ë Copy of related pay stub, 1099 form for prior year, and possibly a letter
Salary/Wages
from the employer on company letterhead.
Ë Copy of all W-2 forms submitted with the prior year income tax return.
Gratuities/Tips
Copy of all pay stubs for the most recent one-month period.
Ë Copy of current month’s pay stubs, letter from employer estimating
Cash Advances
monthly gratuities earned, and W-2 form for the prior year.
Ë Copy of all pay stubs documenting cash advances.
Spouse (Significant Other’s) Salary/Wages
Cash Bonuses
Ë Copy of all W-2 forms submitted with the prior year income tax return.
Ë Copy of all pay stubs documenting cash bonuses, and copy of related
Copy of all pay stubs for the most recent one-month period.
1099 form.
Other Joint Spousal Income
Commissions
Ë Documentation verifying any monthly income jointly earned with the
Ë Copy of all 1099 forms submitted with the prior year income tax return.
spouse or significant other, (e.g., income from the spouse or significant
other or income from a business owned or controlled by the spouse or
significant other, that the defendant has a joint ownership interest in, or
Business Income
controls).
Ë Copy of the past six monthly financial statements of all businesses
owned or controlled by the defendant. Also, be sure to provide all
Income of Others in the Home
financial information requested in the “Assets” portion of the “Net
Ë Verification of the monthly earnings of all others living in the
Worth Statement” under “Section K, Business Holdings.”
defendant’s household (e.g., all pay stubs for the prior month, W-2
forms, and 1099 forms for the prior year), paid receipts or canceled
Interest/Dividends
checks for necessary monthly household expenditures (e.g., for food,
Ë Copy of most recent earnings statement from a financial institution (e.g.,
room rental, telephone, transportation, etc.) actually paid by this person
bank, brokerage firm, etc.). Copy of all 1099-INT forms, reporting
on behalf of the defendant.
annual interest earnings, for the past year.
Gifts From Family
Rental Income
Ë A signed and dated statement from the family member who gave gifts
Ë Copy of lease rental agreement, copy of monthly rental check received,
to the defendant during the month, listing the amounts, dates and
and copy of the deposit on the defendant’s monthly bank statement.
reasons given, and a copy of the check received, if any.
Trust Income
Gifts From Others
Ë Copy of the monthly trust income check, copy of the trust agreement,
Ë A signed and dated statement from the person(s) who gave gifts to
and a copy of the trust income tax return for the prior year.
the defendant during the month, listing the amounts, dates and
reasons given, and a copy of the check received, if any.
Alimony/Child Support
Loans From Your Business
Ë Copy of divorce decree, copy of payments received, and statements
Ë Copy of the past six monthly financial statements of all businesses
documenting child support/alimony obligations with payment history.
owned or controlled by the defendant that loaned money to the
defendant, including a detailed schedule of the “Loans To
Social Security
Shareholder/Owner” or “Due From Shareholder/Owner” general ledger
Ë Copy of most recent Social Security check and most recent benefits
accounts.
determination letter.
Mortgage Loans
Ë Copy of all mortgage checks received during the prior month, 1099
Other Government Benefits
forms submitted with the prior year tax return, and copy of the sales
Ë Copy of most recent government subsidy check (e.g., unemployment
agreement and escrow statement for all mortgage loans owed to the
compensation, or child support/alimony) and most recent benefits
defendant.
Other Loans
determination letter.
Ë Copy of loan documentation and copy of all loan checks received
Pensions/Annuities
during the prior month.
Ë Copy of pension/annuity check, copy of most recent pension plan
activity statement or annuity statement, and copy of pension plan or
Other (specify)
annuity contract.
Ë Documentation verifying the source of all other monthly cash inflows
(not yet disclosed or reported in these financial statements) and copy of
all related monthly checks received.
OPROB 48C
Page 2 of 2
(9/00)
REQUEST FOR MONTHLY CASH FLOW STATEMENT FINANCIAL RECORDS (cont.)
Credit Card Payments
NECESSARY MONTHLY CASH OUTFLOWS
Ë Copy of most current billing statement for all charge accounts (e.g.,
Rent or Mortgage (including taxes)
credit cards, revolving charge cards, and department store cards) and
Ë Copy of apartment rental lease agreement or home mortgage, most
lines of credit (e.g., bank line of credit).
recent mortgage statement, and copy of canceled check.
Medical
Groceries (# of people)
Ë Documentation of medical expenses (e.g., billing statements,
Ë Grocery receipts with corresponding canceled checks (if applicable)
payment receipts, and canceled checks).
for the past month.
Alimony/Child Support
Utilities
Ë Copy of divorce decree, canceled checks, and statements documenting
Ë Copy of most current utility bills (e.g., electric, heating oil/gas,
child support/alimony obligations with payment history.
water/sewer, telephone, and basic cable).
Co-payments (electronic monitoring, drug/mental health treatment)
Transportation
Ë Canceled check along with statement from the service provider (if any).
Ë Current month gasoline/motor oil receipts and corresponding canceled
Other (specify)
checks (if applicable), and gasoline credit card statements for the prior
month.
Ë Specific receipts, billing statements, and corresponding canceled checks.
Insurance
Ë Copy of most current insurance bills for all types of insurance (auto,
health, life, homeowners).
Clothing
Purchase receipts with corresponding canceled checks.
Loan Payments
Ë Copy of loan statements (including motor vehicle payment book and
lines of credit) for all loans. Also, provide a copy of any financial
statements submitted to obtain credit in the past three years.
ADDITIONAL INSTRUCTIONS:
A personal interview has been scheduled for you with:
on
U.S. Probation Officer
Date
at
Office Location
Time
Telephone
Print
Save As...
Reset
Page of 2