Sample Report

Sample Report
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(00) Agency Title (00) Bureau Title (00000) Entity Title (X) Type
First Quarter 2006

Part I - Status of Receivables
	Number	Dollars
Section A Receivables and Collections

1	Beginning FY Balance
2	New Receivables (+)
3	Accruals (+)
4	Collections on Receivables (-)
	(A) At Agency (-)
	(B) At Third Party (-)
	(C) Asset Sales (-)
	(D) Collections by Treasury through Offset and Cross-Servicing (-)
	(E) Collections by Sale After Foreclosure (-)
	(F) Collections by Department of Justice (-)
	(G) Other - must footnote (-)
5	Adjustments (+ or -)
	(A) Reclassified/Adjusted Amounts (+ or -)
	(B) Adjustments Due to Sale of Assets (+ or -)
	(C) Consolidations (+ or -)
	(D) Foreclosure Adjustments (+ or -)
	(E) Written-Off Debts Reinstated for Collection (+)
6	Amounts Written Off (-)
	(A) Currently Not Collectible (-)
	(B) Written Off and Closed Out (-)
7	Ending Balance

Section B
Additional Receivables Data (Information Only)

1	Subsets of Ending Balance
	(A) Foreign/Sovereign Government (+)
	(B) State and Local Government (+)
	(C) Rescheduled Debt - Delinquent (+)
	(D) Rescheduled Debt - Non-Delinquent (+)
	(E) Interest & Late Charges (+)

Section C
Delinquent Debt (Excluding CNC Debts)

2	Delinquencies by Category
	(A) Commercial (+)
	(B) Consumer (+)
	(C) Foreign/Sovereign Government (+)
	(D) State and Local Government (+)
	(E) Total Delinquencies by Category

Part II - Debt Management Tool and Technique Performance Data
	Number	Dollars
Section A Delinquent Debt 180 Days or Less

1	Delinquencies 1-180 Days
	(A) In Bankruptcy (+)
	(B) In Forbearance or In Formal Appeals Process (+)
	(C) In Foreclosure (+)
	(D) At Private Collection Agencies (+)
	(E) In Litigation (At DOJ or Agency Counsel) (+)
	(F) In the Process of Internal Offset (+)
	(G) In Wage Garnishment (+)
	(H) At Treasury for Cross Servicing (+)
	(I) At Treasury for Offset (+)
	(J) At Agency (+)
	(K) Other - must footnote (+)
	(L) Total Delinquencies 1-180 Days

Section B
Delinquent Debt (Over 180 Days Delinquent) Eligible for Referral to Treasury for Offset and Cross-Servicing

1	Debt Eligible for Referral to Treasury for Collection
	(A) Delinquent Debt Over 180 Days (+)
	(B) Currently Not Collectible Debt (+)
	(C) Total Delinquent Debt Over 180 Days and CNC Debts

Debts Ineligible for Treasury Offset Program (TOP) and Cross-Servicing (lines D through G)

	(D) In Bankruptcy (-)
	(E) In Forbearance or Formal Appeals Process (including Litigation) (-)
	(F) In Foreclosure (-)
	(G) Other - must footnote (+ or -)
	(H) Balance of Debt Eligible for Referral to Treasury for Collection

2	Debt Eligible for Referral to Treasury Offset Program
	(A) Debt Eligible for Referral to Treasury for Collection (from 1H)
	(B) Foreign/Sovereign Debt (-)
	(C) Debt in Litigation for Enforced Collection (-)
	(D) Other - must footnote (+ or -)
	(E) Debt Required to be Referred to Treasury Offset Program by Agency
	(F) Debt Referred to Treasury Offset Program (-)
	(G) Debt Referred to Treasury Offset Program through Cross-Servicing (-)
	(H) Balance Remaining to be Referred

3	Debt Eligible for Referral to Treasury or a Designated Debt Collection Center for Cross-Servicing
	(A) Debt Eligible for Referral to Treasury for Collection (from 1H)
	(B) Foreign/Sovereign Debt (-)
	(C) Debt in Litigation for Enforced Collection (-)
	(D) At Private Collection Agencies (-)
	(E) In the Process of Internal Offset (-)
	(F) Debt Exempted by Treasury from Cross-Servicing (-)
	(G) Debt Returned from Cross-Servicing (-)
	(H) Other - must footnote (+ or -)
	(I) Debt Required to be Referred to Treasury or a Designated Debt Collection Center for Cross-Servicing
	(J) Debt Referred to Treasury or a Designated Debt Collection Center for Cross-Servicing (-)
	(K) Balance Remaining to be Referred

Section C
Collections on Delinquent Debt

1	Collections of Delinquent Debt
	(A) By Private Collection Agencies (+)
	(B) By Litigation (+)
	(C) By Internal Offset (+)
	(D) By Third Party (+)
	(E) By Asset Sales (+)
	(F) By Wage Garnishment (+)
	(G) By Treasury / Designated Debt Collection Center Cross Servicing (+)
	(H) By Treasury Offset (+)
	(I) By Agency (+)
	(J) Other - must footnote (+)
	(K) Total Collections on Delinquent Debt

Section D
CNC Debt Status

1	Currently Not Collectible Debts (Written Off and Not Closed Out)
	(A) At Private Collection Agencies (+)
	(B) At Treasury or a Designated Debt Collection Center for Cross Servicing (+)
	(C) At Treasury for Offset (+)
	(D) Other - must footnote (+)
	(E) Total - Currently Not Collectible Debts (1A-D not mutually exclusive)
2	CNC Debts Closed Out During the Current FY (+)

Section E
Disposition of Closed-Out Debts

1	Debts Closed Out During the Previous Calendar Year (CNC and Non-CNC Debts) (+)
	(A) Reported to IRS on Form 1099-C (+)
	(B) Not Reported to IRS on Form 1099-C - (must footnote) (1-1A)

Part III - Footnotes

Agency Contact Information