Monetary Instrument Sales Log

Log recording cash sales of monetary instruments (cashier's checks, money orders, traveler's checks, bank drafts) between $3,000 and $10,000 per BSA 31 CFR § 1010.415 recordkeeping requirements.

Submission Notice

• I confirm this transaction was funded with cash and the instrument amount is between $3,000 and $10,000 (inclusive)
  BSA 31 CFR § 1010.415 applies only to cash-funded purchases. Check this box to confirm eligibility before proceeding.

Transaction Details

• Transaction Date
  Date the monetary instrument was sold to the purchaser.
• Transaction Time
  Time of sale (local branch time).
• Type of Monetary Instrument
  Select the type of instrument sold. Per 31 CFR § 1010.415(a), covered instruments include cashier's checks, money orders, traveler's checks, and bank drafts.
• Other Instrument Type — Description
• Instrument Amount (USD)
  Face value of the monetary instrument in U.S. dollars. Must be between $3,000.00 and $10,000.00 to require this log entry.
• Instrument Serial / Check Number
  Serial or check number printed on the instrument for audit trail purposes.
• Payee Name (as printed on instrument)
  Name of the payee or 'Pay to the Order of' as written on the instrument.

Purchaser Identity

• Purchaser Full Legal Name
  Full legal name as it appears on the government-issued photo ID presented.
• Purchaser Street Address
  Permanent residential street address (no P.O. Box).
• Purchaser Date of Birth
  Date of birth as shown on the government-issued ID. Collected for identity verification only; handled per institution data minimization policy.
• Government-Issued Photo ID Type
  Type of ID presented by the purchaser for identity verification.
• ID Number
  ID number as printed on the document (e.g., driver's license number, passport number).
• ID Issuing State / Country
  State (for U.S. licenses/IDs) or country (for passports) that issued the identification document.
• ID Expiration Date
  Expiration date on the presented ID. Expired IDs should not be accepted as valid verification.
• Is the purchaser an established customer of this institution?
  Per 31 CFR § 1010.415(b)(1), if the purchaser is an established customer, record their account number in lieu of re-verifying identity.
• Customer Account Number
  For established customers, record the account number on file. This satisfies the identity verification requirement under 31 CFR § 1010.415(b)(1).

Suspicious Activity Screening

• Were any structuring or suspicious activity indicators observed?
  Indicators include: purchaser mentions avoiding reporting, multiple instruments purchased to stay under $10,000, third party providing cash, unusual nervousness, or inconsistency between stated purpose and transaction.
• Describe the Suspicious Activity Indicators Observed
  Provide a factual, objective description of the behavior or statements that raised concern. Do NOT notify the customer. Forward to BSA/AML Officer for SAR evaluation.
• Has this transaction been referred to the BSA/AML Officer for SAR review?
  Check yes if you have already escalated this transaction. The BSA/AML Officer must determine whether a SAR filing is required within 30 days of detection.

Issuing Teller and Branch Information

• Branch Name / Location
• Branch ABA Routing Number (optional)
  Nine-digit ABA routing number for the issuing branch, if applicable.
• Teller / Associate Full Name
  Full name of the teller or associate who processed the transaction and is completing this record.
• Teller Employee ID
• Was a supervisor notified of this transaction?
• Supervisor Name
• Additional Notes
  Any additional context relevant to this transaction record. Do not include information that belongs in a SAR narrative here.