Title Page
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Terminal ID
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Location / Site Address
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Bank Name
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Site Name
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Date Visited
1. Personnel Detail
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1.1 Driver Name
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1.2 Crew / Custodian Name
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1.3 Third Man Name
2. Service
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2.1 Service Type
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2.2 Non Trip
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2.3 Missed Service
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2.4 Reason & OB Number
3. Check ATM
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3.1 Is the ATM in working order ?
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3.2 Are electronic keys operational?
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3.3 Are the lights working inside the ATM cubicle?
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3.4 Is the access door secure?
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3.5 Is the access door locked?
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3.6 Is the ATM alarm in working order?
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3.7 SMS signal received?
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3.8 Is UPS installed at the site?
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3.9 Are ATM canisters marked correctly?
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3.10 Are all canisters operational?
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3.11 Is the purge bin operational?
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3.12 Paper levels checked and in order?
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3.13 Is the printer in a working condition?
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3.14 Is the ATM neat and tidy?
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3.15 Are canisters loaded correctly?
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3.16 Is a test dispense done after the new load?
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3.17 Did you correctly received the ATM slips?
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3.18 Are the safe doors correctly secured after service is conducted?
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4. Include photos of the ATM slips.
5. Values (ATM)
5.1 Balance (Slip)
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5.1.1 Balance of R20 as per slip
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5.1.2 Balance of R50 as per slip
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5.1.3 Balance of R100 as per slip
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5.1.4 Balance of R200 as per slip
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5.1.5 Total Balance as per slip
6.1 Purge bin Totals
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6.1.1 Balance of R20 in purge bin
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6.1.2 Balance of R50 in purge bin
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6.1.3 Balance of R100 in purge bin
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6.1.4 Balance of R200 in purge bin
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6.1.5 Total Balance in purge bin
7.1 Cash Loaded Totals
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7.1.1 Balance of R20 loaded
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7.1.2 Balance of R50 loaded
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7.1.3 Balance of R100 loaded
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7.1.4 Balance of R200 loaded
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7.1.5 Total Balance loaded
8.1 Balance Dispensed as per ATM
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8.1.1 Balance of R20 dispensed as per ATM
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8.1.2 Balance of R50 dispensed as per ATM
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8.1.3 Balance of R100 dispensed as per ATM
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8.1.4 Balance of R200 dispensed as per ATM
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8.1.5 Total Balance Dispensed as per ATM
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9. Serial Numbers of all bags / canisters returned to CMC
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Name of Custodian conducting service
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Signature of Custodian
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Date Signed
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10. To be completed by the Debrief Manager
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10.1 All Non Services coded correctly? YES NO
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10.2 All cassettes/bags scanned to correct job line? YES NO
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10.3 Did crew scan onto e-viper? YES NO
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10.4 All slips received? YES NO
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10.5 Were all services carried out? YES NO
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10.6 Auditor present during swop? YES NO
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10.7 Discrepancy identified – Branch Manager notified? YES NO
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10.8 CCTV arranged with BSO? [OB Number: ___________________________________________________]
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Debrief Manager Name & Surname: [ ___________________________________________________________________________________________________]
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Debrief Manager Signature: [__________________________________________________]
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Date Checked by Debrief Manager: [__________________________________________________]
