FOR ENGLAND AND WALES
Accounts
Chaiity tbame
Chaity nurnbet (Ifany)
•IIDtIlE
For the period frorn (slait dale) t￿￿
ThEY￿ll
Section A
Receipts and payments
Ijnfestiicted
funds
to ￿les1
Restiicted
funds
io the neare
EThdowment
Total lunds
Lasl year
lo the Treaie5t
to the neatest
to the nearest
Al Recelpts
b totol
A2 Asset and inveslmont sa14 et<
rotoliÈYwls
A3 Paym￿ts
Sub toial
SIL
A4 Assd and imTeslment purcha$4 ett
Toiolpayments
Netof Keceipt5/lpoyments}
A5 Transfers bet*ren fvnds
CSLÈ
A6 Cash funds last yearend
Cosh lunds thi5 yeoi end
CC16a
March 201L" new lomiat January 2017

Section B
statement of assets and liabilities at the end of the period
Vnrestiicted
funds
to tt* nfyire51
Restricted
funds
to I￿reSt
EndowfflÈnt
funds
to the t>eaiest
Detai15
81 (ash I￿ndS
(ryieebolthKe5 W7threceiptsoThlpoy>Trntsoc(wnr(s))
Unrestricted
funds
the Deaiesi
Re5tiicted
funds
to the [￿are51
Endowtnent
luThds
to the nearest
Details
B2 Other monetary assets
Fund to which
asset belongs
Cost
{option411
Currenl value
loptionall
Oetalls
B3 Investnwit Jssels
Fund to which
a$5eL belongs
Cost
<optional>
Currefit value
(oplional)
Details
Fund lo which
liability felates
Amount due
(optional)
When due
{optional)
Details
BS Liabifitie5
Signed by one 01 two trustees on behalf
ol all Ihe Iiustees
S¥Jfiature
Print fiarne
Date ol approval
otk4