East District Financial Report Form

 

East District Committee Financial Report

Committee Name:      ______________           Date: ___/____/______
Chairpersons Name:   ______________          (Report the first day of Apr, Jul, Oct, Jan.)
                                                                            Qtr. Beginning Bal: $________

                                                                          

                                                                            Qtr. End Balance:    $________
Transactions:

Please state the source of your Deposits and/or purpose of your Withdrawal:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Are funds in:  BANK –  OTHER  (circle one)  Bank Name:__________Act#:_________

If other, please explain: _________________________________________________

Committee Chairman Signature: ___________________________

                       Date Submitted: ____/______/______