Advertising Media Billing Reconciliation Form

Please complete all sections diligently to ensure accurate reconciliation of billed advertising media with actual expenditures. Provide detailed information for each part to streamline a thorough review and approval process.

Date: [Month Day, Year]

General Information

Name:	[Client’s Name]
Campaign Name:	[Campaign Name]
Campaign Period:	[Month Day, Year] - [Month Day, Year]
Account Manager:	[Account Manager’s Name]

Billed Advertising Media

Media Type	Placement	Billed Amount	Billing Date
Television	TV Network	$15,000	March 15, 2050

Actual Media Spend

Media Type	Placement	Amount Spent	Payment Date
Television	TV Network	$14,500	March 30, 2050

Reconciliation Summary

Total Billed Amount:	$32,000
Actual Amount Spent:
Difference:

Approval

[Approver's Name]

[Approver's Job Title]

Date: [Month Day, Year]

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