PERI Chapter Financial Report VCMS Chapter Forms

PERI Chapter Financial Report

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

Indicates required field

Email Address

Confirm Email Address

County:

Chapter Number:

District Number

Beginning Date

Ending Date

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:

Total of Cash on Hand plus Income:

Disbursements (Bills paid)

Total Disbursements:

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

Treasurer - Digital Signature:

Date of Digital Signature for Treasurer

Chapter Audit Committee Chair - Digital Signature:

Date of Digital Signature for Chair