PERI Chapter Financial Report

614-891-6868

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This form should be sent to your District Rep and PERI state office no later than February 15th of each year

Email Address(Required)

Enter Email Confirm Email

County:(Required)

Chapter Number:(Required)

District Number(Required)

Beginning Date(Required)

Ending Date(Required)

Cash on Hand (Balance in checkbook on beginning date shown above) (This amount should also be the ending balance shown on last month's report):

Income (Dues):

Income (Gifts):

Other Income:

Total Income for Month:(Required)

Total of Cash on Hand Plus Income:(Required)

Disbursements (Bills Paid)(Required)

Total Disbursements:

Ending Balance (The ending balance should be the amount in the checkbook on the ending date shown above):(Required)

Treasurer – Digital Signature:(Required)

Date of Digital Signature for Treasurer(Required)

Chapter Audit Committee Chair – Digital Signature:(Required)

Date of Digital Signature for Chair

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