|~|o|i|~|~|i ~|||a ~||
|---|---|---|---|---|---|---|---|---|---|
|||||||Unrestricted|Restricted||Endowment|
||Categories|||Details||funds||funds|funds|
|||||||toneereet a|||to neareat a|
|||||Bank acccuttt||||||
||||||Total cash funds|Ot,OOO||||
|||||(agtee balances|with recelpat ant) paymente|||||
||||||eccount(e))|GK|QK||Q t('|
|||||||Unrestricted|Restricted||Endowment|
|||||||funds||funds|funds|
|||||Details||to nearest R|to|nearest R|to nearest a|
|82Other|monetary assets|||||||||
|||||||Fund to which<br>asset balan|c<br>l)<br>Cost (optional)||Current value<br>o<br>ional|
|B3Investment||assets||||||||
|||||Details||Fundtowhlch <br>asset helen s|C,||Currentvalue<br>o tlonsl|
|B4Assets retained for the||||||||||
|charity's|own|use||||||||
|||||||Fund to which|Amount due||When due|
|||||Details||uaba<br>relates||I nal|o tlonal|
|B5Liabilities||||||||||
|Signed by one or two trustees on<br>behalf of all the trustees||||Signature||Print Name|||Date of<br>a<br>roval|
|||||||HtcoM|VAmoS||t'. .ZZ|
|||||||trA41HA|QQAIH884]W||8' 5 - 2 2|





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