Citibank® Commercial Cards

Appendix C: Report Formats

Report Name: Payment Performance and Refund Report (C.38.2.i)
Report Number: N/A
Frequencies Available: Quarterly, annually
Level of Detail Selected: Detail
Dollars Reflected on Report: Real
Sort Order: N/A
Agency Benefits: Track Agency payment performance

Report Description
This report lists the payment performance and any refunds paid to the Agency/Organization.

Feature 1.1.10 Payment Performance (C.38.2.i)

Pictorial Depiction
Payment Performance Site Name
<Event/Posting/Transaction/Processing> date for dynamic data rage: <date range>
<hierarchy level>
Level of Detail: <list of LCD items>
[No] additional scoping parameters are in effect.
Unit Name Unit ID
XXXXXXXXXXXXXXXXXXXX 999999999

Item Date Debit Credit Balance Performance
Previous Balance       999,999.99  
Cycle 1 Invoice MM/DD/YYYY 999,999.99   999,999.99 9999
Payment MM/DD/YYYY   999,999.99 999,999.99  
Cycle 2 Invoice MM/DD/YYYY 999,999.99   999,999.99 9999
Payment MM/DD/YYYY   999,999.99 999,999.99  
Cycle 3 Invoice MM/DD/YYYY 999,999.99   999,999.99 9999
Payment MM/DD/YYYY   999,999.99 999,999.99  
<refund type> MM/DD/YYYY   999,999.99 999,999.99  
           
NET TOTAL   999,999.99 999,999.99 999,999.99 Avg: 9999

Unit Name Unit ID
XXXXXXXXXXXXXXXXXXXX 999999999

Item Date Debit Credit Balance Performance
Previous Balance       999,999.99  
Cycle 1 Invoice MM/DD/YYYY 999,999.99   999,999.99 9999
Payment MM/DD/YYYY   999,999.99 999,999.99  
Cycle 2 Invoice MM/DD/YYYY 999,999.99   999,999.99 9999
Payment MM/DD/YYYY   999,999.99 999,999.99  
Cycle 3 Invoice MM/DD/YYYY 999,999.99   999,999.99 9999
Payment MM/DD/YYYY   999,999.99 999,999.99  
<refund type> MM/DD/YYYY   999,999.99 999,999.99  
           
NET TOTAL   999,999.99 999,999.99 999,999.99 Avg: 9999
Run Date/Time 12/5/1997 4:50pm  Page 1 of 1

Payment Performance and Refund Report:
Report Description: This report lists payment performance (average payment time) and any refunds paid to the Agency/Organization level.
Report Name: Payment Performance and Refund Report:
Solicitation Reference Number: C.38.2.i
Report Date: mm/dd/yyyy

Report Number: XXXXXXXX
Page: nnnn

Agency/Organization Name ID Number Net Charge Volume Refund Amt. On Charge Volume Reproductivity Refund Amount Total Refund Amount Average Payment Time
xxxxxxxxxx xxxxxxx $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ nnn
xxxxxxxxxx xxxxxxx $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ nnn
xxxxxxxxxx xxxxxxx $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ nnn
xxxxxxxxxx xxxxxxx $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ nnn
xxxxxxxxxx xxxxxxx $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ nnn
xxxxxxxxxx xxxxxxx $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ nnn
xxxxxxxxxx xxxxxxx $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ nnn
xxxxxxxxxx xxxxxxx $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ nnn
xxxxxxxxxx xxxxxxx $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ $$$,$$$.$$ nnn