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Run: Monetary Instrument Sales Log

Monetary Instrument Sales Log records cash sales of cashier's checks, money orders, traveler's checks, and bank drafts between $3,000 and $10,000. Use it to ...

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Submission Notice

I confirm this transaction was funded with cash and the instrument amount is between $3,000 and $10,000 (inclusive) (required)

BSA 31 CFR § 1010.415 applies only to cash-funded purchases. Check this box to confirm eligibility before proceeding.

Yes No N/A

Transaction Details

Transaction Date (required)

Date the monetary instrument was sold to the purchaser.

Transaction Time (required)

Time of sale (local branch time).

Type of Monetary Instrument (required)

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) (required)

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 (required)

Serial or check number printed on the instrument for audit trail purposes.

Payee Name (as printed on instrument) (required)

Name of the payee or 'Pay to the Order of' as written on the instrument.

Purchaser Identity

Purchaser Full Legal Name (required)

Full legal name as it appears on the government-issued photo ID presented.

Purchaser Street Address (required)

Permanent residential street address (no P.O. Box).

Purchaser Date of Birth (required)

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 (required)

Type of ID presented by the purchaser for identity verification.

ID Number (required)

ID number as printed on the document (e.g., driver's license number, passport number).

ID Issuing State / Country (required)

State (for U.S. licenses/IDs) or country (for passports) that issued the identification document.

ID Expiration Date (required)

Expiration date on the presented ID. Expired IDs should not be accepted as valid verification.

Is the purchaser an established customer of this institution? (required)

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? (required)

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 (required)

Branch ABA Routing Number (optional)

Nine-digit ABA routing number for the issuing branch, if applicable.

Teller / Associate Full Name (required)

Full name of the teller or associate who processed the transaction and is completing this record.

Teller Employee ID (required)

Was a supervisor notified of this transaction? (required)

Supervisor Name

Additional Notes

Any additional context relevant to this transaction record. Do not include information that belongs in a SAR narrative here.

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