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Sample Form - IIM Statement of Account 1

DATE – Date of each account transaction during the statement period.

TRANSACTION DESCRIPTION – This column describes the transactions, such as cash receipts and disbursements (funds coming into and out of the account) including the names of payers and types of leases (sources of payments and funds that were disbursed).

CASH – This column shows funds received into the account from sources such as leases or interest payments and funds that were disbursed to the account holder. Funds that were disbursed are preceded by a minus sign indicating a deduction from the account.

Start and end dates for the transaction activity included in the statement. The timeframe in this example is the fourth quarter of 2009.

Name and IIM account number of the account holder. This account number is also used for the ITI Report. (See ITI Report for an explanation of what each part of the account number means.)

Toll-free number for account holders to call if they have questions about their statement or their account. All callers must be able to verify that they are or have at one time been an IIM account holder.

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