MONTGOMERY COUNTY PUBLIC SCHOOLS
SFO ESCHEATMENT
Checks to be Escheated for FYXX (dated prior to July 1, 20XX)
DATE:
SCHOOL NAME
SCHOOL NUMBER
PRINCIPAL NAME
PRINCIPAL SIGNATURE
DATE
CHECK
NUMBER
1
2
3
4
5
6
7
8
9
10
Total
CHECK
DATE
CHECK
AMOUNT
VENDOR NAME
SSN/TIN
STREET ADDRESS
CITY
STATE
ZIP