POSTMARKED BY: May 15, 2011
CHAPTER TREASURER SEND ORIGINAL TO:
Susan Rickards, Executive Director
P.O. Box 329, Fairmont, WV 26555
COPY TO: Region Councilor, Chapter Files
ANNUAL TREASURER'S REPORT-ALUMNI
ALUMNI CHAPTER
DATE
CITY
REGION____________
INSTRUCTIONS TO CHAPTER TREASURER. You are responsible for preparing and submitting these financial
statements. Before preparing this report, accounting entries for the period must be brought up to date and
posted, the books closed, a trial balance taken, all accounts must be balanced and all bank accounts must be
reconciled.
PART I: FINANCIAL STATEMENT FOR FISCAL YEAR MAY 1, 2009 to April 30, 2010.
REVENUE
BEGINNING BALANCE May 1, 2009
(a) $__________
INCOME:
FEES Local Fees
TOTAL FEES
No.
@$
ea.
EARNED Gifts, Contributions, etc.
Investment Interest
Sale of (specify)___________________
Banquets and Luncheons
Merchandise
Reimbursement (s) National Office
Savings
Other (specify)____________________
TOTAL EARNED
TOTAL INCOME (b + c)
BEGINNING BALANCE and INCOME (a + d)
(b)$__________
$__________
$__________
$__________
$__________
$__________
$__________
$__________
$__________
(c)$__________
(d)$__________
(e)$__________
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DISBURSEMENTS
CHAPTER EXPENSES Income Making Projects
Banquets and Luncheons
Merchandise
Correspondence and Telephone
Supplies
Conclave
Audit and Bank Charges
Contributions - Nat’l Ed. Foundation
Nat’l Professional Project
Local Scholarship(s)
Professional Project
Founder’s Day
District Workshop
Social Meetings, Recognition and PR
Other (specify)
TOTAL CHAPTER DISBURSEMENTS
$__________
$__________
$__________
$__________
$__________
$__________
$__________
$__________
$__________
$__________
$__________
$__________
$__________
$__________
$__________
(h) $__________
NET BALANCE
BEGINNING BALANCE and INCOME (e)
TOTAL DISBURSEMENTS (h)
ENDING BALANCE APRIL 30, 2010 (e - h)
PART II:
INVESTMENTS
Name and Location of
Bank or Institution
$__________
$__________
$__________
Account
Number
Maturity
Date
Interest
Rate
Amount
Checking Account(s)
Savings Account(s)
Other(s) - Specify Type
(i.e., CD, Money Markets, Endowments)
PART III: AUDIT
Financial records last audited by __________________________________________ Date__________________________
NOTE: Financial records should be closed by April 30th of each calendar year and ready for audit. (See Letter)
PART IV: SCHOLARSHIP RECIPIENTS - (Indicate Amounts - Must match Part I under heading “Local Scholarships.”)
List name(s) and address(es) below.
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
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Part V: CHAPTER TREASURER
Treasurer for 2010-2011:
NAME _______________________________________________________________
ADDRESS_____________________________________________________________
E-MAIL _______________________________________________________________
PART VI: DECLARATION
According to the Internal Revenue Service, "Every year, each local organization must authorize the central organization
in writing to include it in the group return and must declare, under penalty of perjury, that the authorization and
information it submits to be included in the group return are true and complete."
Therefore, to be included in the Group 990 tax return, you need to complete the following:
____________________________________________Chapter of Phi Upsilon Omicron requests that the chapter's financial
information be included in the group return. To the best of my knowledge and belief, the treasurer's annual report is
true, correct and complete.
__________________________________
Signature of Treasurer (Submitting Report)
Signature of Chair, Audit Committee
Web Site: http://www.phiu.org
8/09
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