Appendix 7
TRANSMITTAL AND REPORT CERTIFICATION MEMOS
This appendix provides 2 templates:
Template #1 is to be used for certification of the SAM 99 file and the transmission and certification of hard copy reports for active governmental funds. Space for contact information is provided in three places in the event the contact for the SAM 99 is different from the contacts for special reports and supplemental forms. If the contact is the same for the SAM 99, the special reports and the supplemental forms, provide the contact only once and delete the other contact sections from the transmittal.
Note: The SCO no longer requires the CSU to submit Reports 18 and 19, but these reports remain required submissions for all other state agencies. Campuses must list Report 18 on all certifications they submit and both Report 18 and Report 19 on the certification for state fund 0001, General Fund. The template reflects the submission status for these reports as “Not required per CSA and SCO”. Do not change this message.
Template #2is to be used for the transmission and certification of hard copy reports for non-governmental funds. Space for contact information is provided in three places in the event the contacts for the hard copy reports, special reports and the supplemental forms are all different. If the contact is the same for these reports, provide the contact only once and delete the other contact sections from the transmittal.
Note: The Chancellor’s Office submits reports for most of these funds on a consolidated basis. However, if your campus needs to file reports for state fund 0890, Federal Trust Fund, and/or state fund 0942, Special Deposit Fund, neither of which is included in the SAM 99 file, the certification format of Template #2 will need to be used.
DO NOT include text in red in campus submissions. Red text provides additional instructions only.
Revised 2/16/15
TEMPLATE 1 – FOR ACTIVE GOVERNMENTAL FUNDS SUBMITTED THROUGH SAM99
Memorandum
Date:
To:State Controller’s Office
Division of Accounting and Reporting
State Government Reporting
P.O. Box 942850
Sacramento, CA94250-5872
From: California State University, [Campus Name (Agency Number)]
[Campus Address]
[City Name, CA 9xxxx]
President [Name] Email address: [Insert President’s email address]
Subject:Certification of Year-End Financial Reports
[FUND NAME AND NUMBER]
The SAM99 electronic file for the fiscal year ended June 30, 20XX was submitted to your office on [Date] for the referenced fund in lieu of Reports 1, 2, 4, 5, 7, 8 and 15 in accordance with instructions from the State Department of Finance, the State Controller, and the California State University Chancellor’s Office.
In addition,Report 3, Adjustments to Controller’s Accounts, is being submitted in hard-copy form and is enclosed.
OR (do not include both sentences in the certification)
Report 3, Adjustments to Controller’s Accounts, is not applicable for this fund and, therefore, is not part of this submission.
Contact Person: [Name]
Phone No: [Number]
Email: [Email Address]
Special Reports
The following hard-copy special reports are enclosed: [Note: Include Reports 14 and 19 on the certification for General Fund only.]
Report No. / Description / Enclosed / No Activity to Report14 / Bank Accounts Outside the State Treasury System / X
18 / Statement of Changes in General Fixed Assets / Not required per CSA and SCO
19 / Statement of General Fixed Assets / Not required per CSA and SCO
22 / Statement of Contingent Liabilities
Include on certifications for funds other than the General Fund:
Report 14 is included with reports for the General Fund.
Contact Person: [Name]
Phone No: [Number]
Email: [Email address]
Supplemental Forms
Report No. / Description / Enclosed / No Activity to ReportN/A / Due To/From Other Funds/Appropriations Supplemental Form
N/A / Material Variance Explanation Form / X
Contact Person: [Name]
Phone No: [Number]
Email: [Email address]
I hereby certify (or declare) under penalty of perjury that the data in the electronic file and on the attached reports is true and correct and that I have not violated any of the provisions of Article IV, Chapter 1, Division 4, Title I, Government Code (commencing with Section 1090).
Subscribed and executed this ____ day of July, 20XX at ______, California.
Signed:
Type name:
Title: Vice President, Administration & Finance
Email address:
TEMPLATE 2 – FOR NON-GOVERNMENTAL FUNDS SUBMITTED IN HARD-COPY FORMAT
Memorandum
Date:
To:State Controller’s Office
Division of Accounting and Reporting
State Government Reporting
P.O. Box 942850
Sacramento, CA94250-5872
From: California State University, [Campus Name (Agency Number)]
[Campus Address]
[City Name, CA 9xxxx]
President [Name}Email address: [Insert President’s email address]
Subject:Certification of Year-End Financial Reports
[FUND NAME AND NUMBER]
Following is the submission status of the listed reports for the referenced fund for the fiscal year ended June 30, 20XX:
Report No. / Description / Enclosed / Not Applicable3 / Adjustments to Controller’s Accts.
7 / Pre-Closing Trial Balance / X
8 / Post-Closing Trial Balance / X
9 / Statement of Operations / X
20 / Statement of Financial Condition / X
Contact Person: [Name]
Phone No: [Number]
Email: [Email Address]
Special Reports
The following hard-copy special reports are enclosed:
Report No. / Description / Enclosed / No Activity to Report18 / Statement of Changes in General Fixed Assets / Not required per CSA and SCO
22 / Statement of Contingent Liabilities
Report 14 is included with reports for the General Fund.
Contact Person: [Name]
Phone No: [Number]
Email: [Email Address]
Supplemental Forms
Report No. / Description / Enclosed / No Activity to ReportN/A / Due To/From Other Funds/Appropriations Supplemental Form
N/A / Material Variance Explanation Form / X
Contact Person: [Name]
Phone No: [Number]
Email: [Email address]
I hereby certify (or declare) under penalty of perjury that the data on the attached reports is true and correct and that I have not violated any of the provisions of Article IV, Chapter 1, Division 4, Title I, Government Code (commencing with Section 1090).
Subscribed and executed this ____ day of July, 20XX at ______California.
Signed:
Type name:
Title: Vice President, Administration & Finance
Email address: