Boxmcmy aThJ Warners Etsj Neighbouth(K¥J Association
Accounts and ttwtts report for the y¢ar eThled 31 MaTch 2021
Charity number 1165570

Report of ¢he Trnstees
for the Y￿r Ended 31 Mareh 2021
INTRoDU￿10N
The Trustees present their report with the financial statement5 of ihe charity ftir the year ended 31
March 2021. The trustees have adopted the provisions of Accounting and Rep)riing by Charities..
Statement of Recommended Practice applicable to clwitie5 prepaTing their accounts in accordance
wilh ihe receipts and payments basis.
This 15 thc fifth reSM)rt for this charity which w&$ re87￿cred in the forni of a Chariiable Incorporated
Organisation (CIO) on the 15 Febrnary 2016 to take over th¢ assets. liabilities and activities of the
Warners End Nei8h¥thood Association (WENA) which was an unincorp)raled registered charily.
registration number 302384. WENA trdnsfeTred its &ssets, liabilities and activities io this ¢harity on
the l April 2016 and subsequently the ComTnunily Cenlre I￿e and all remaining outstanding itern5.
WENA has now been closed and its registrdtion wilh the Chariiy Commission removed.
OBJEcfivES AND AcfiviTIES
Obje¢ts- Th¢ objects of the CIO are=
(a)
to promote the benefit of the inhabitants of the area of benefii without di51indion of
sex, sexual orientation, age. disabilily. nationality. Tace or of political. religious or other
opinions, by associating togeiher the said inhabitants and the staiutory authorities. voluntary
and other organisaiions in a comrnon effort lo advance education and io provide facilities in
the inlere51s olsocial welfare for Tecrealion and leisure-timc occupation with the objecl of
improving the conditions of life for ihe said inhabitants-
Ib)
to eslabli5h. or 5ccure ihe LStablisbmcnt of, a Community Centre and to maintain
and managc ihe sarnc (whcther alone OT in co-operalion wilh any statutory authority or other
person or l￿dy) in furtherance of the Objects"
{c)
to promthe such other chantable purwjses as may from lime to time be delemiined.
The Charity shall be non-party in politics and non-sectarian in religion. The arca of benefil (-area of
benefit") shall be the Dacorum Borou8h Elcctordl Wards of Boxmoor and that part of Chaulden and
Warners End a5 con5tiluted on 3 May 2￿7 10 the ea51 and north of Shrubhill Common.
The m8in &ciivities undeffaken to further the purposes of the charity have been lo improve the
ambicnce and facililies of the Community Cenlr¢ lo make li an ideal choice for users who meet the
needs of our area of benefit. We also run Little Ac(ths Pre-school which 15 OFSTED regisiered and
delivets the Early Years Foundation Stage for 2 to 4 year olds {inclusiv¢). Ai ils last OFSTED
Inspeclion Little Ac0rn5 w&$ rated Go(xl.
The Tn￿leeS in delivering its services have regard to the Charity Commission's guidance on public
benefit.
As well as providing facililies to hire (three meeting rfy)ms and th¢ main hall) of which the majority
of the Ass￿Lation 8en¢ral fvn(ts are devoied (he A&8ociation Tuns a weekly Bingo session, weekly
Internct Café session and a monthly Tea Dance. whil￿ these activitie5 are open to all, the majority
of users are senior ciliz¢n5.
ACHIEVEMENTS AliD PERFORMANCE
Whilst the Associ31ion h&% attempted to run as near norn]al service as ￿Ssible. the Covid-19
pandemic has had a considerable impacl of ihe Association, given in more ddail in Section 4 of this
report. The Community Centre was ¢losed on the 23 March 2020 al￿ remained closed until it
reopened on I. septem￿ 2020. Unforrunatcly. jusi &$ the privale hires began to pick up the Cenlre
was again c105ed (except for a very small number of exempt activiti¢5) on lh¢ 5, November 2020. It
briefly reopened under severe restriclions on 2 December. moved into more severe Tier 4
reslriciion on the 21" December 2020 which in turn turned into another lockdown which lasted in

eff￿1 for the remaindcr of the Financial year. The Litde A¢orns Pre-school also closed on the 23
March 2020 and reopened 15, June 2020. Despite this. the Association continues to keep th¢
Community Centre in good order and has a rolling progTamme of redecoration and is planning lo
continue to improve the facilities of the Centre. The aim of the improvements is to attra¢t of higher
volume of both regular and one-off hiTer5. In respecl of regular hirers, the Association aims lo
attract hirers who deliver services in line with ihe object5 of the Association.
Throu8h its regular hirers there arc nomially many S￿10￿$ run each week which contribule lo a
healthier living and lifestyles of the residents of our area of b¢nefil, however, in thi5 financial year
for a limited period.
In directly providing services itself, the Association seeks io provide services not otherwise
PTovided by its regular hiffrs. In thai respecL whilst the weekly bingo sessions on a Monday
ev￿Ing5 were restored briefly wben ihe Community Cenlre teopened, the previously run monihly
tea dance5 did not ￿Start.
W¢ also ran a wcekly Intemet Café. during the wiods the Centre was open, which enabled
residents without iniernel acce55 to gain access to many seryices that are only easily available
onlin¢. We also allow users to bring in their own LaptOP5 and Tablds. Our volunteers are on hand
at these sessions to assist our users help them out wilh any problems they have. Where we identify a
user in need of trdining. we signp)st ihem to Community Aclion Daconmi (CAD) who now the
courses thai used to be run by DacoTum Communities for Learning wh05¢ Office was based in our
Community Centre until they closed and transfe￿ed their a￿1vIlieS io CAD.
FINANCIAL REVIEW
The whole of ihis financial year was significantly impacted by ihe Covid-19 pandemic. For long
pcriods ihc Communily Centre was closed and even during ihc peri¢Jds the Centre was open hircrs
were very slow lo return. Even after Little Acorns reopcned some children w¢r¢ withheld frotn our
PTe-5chool. This impacted on the income to the Associalion. and had it nol been for Covid Job
Retenlion Scheme IJRS) and Covid Business Support grants would have resulted in a large deficit.
However, as a restslt of thos¢ grants il resulted in a Su￿11 SUTplus of £1.9k in the General Fund5
which compared to lasl Y￿.$ surplus of £3.Sk. In respeet of its restricled funds {for the provision
of the Little Acorns Pre-school) there was a deficit of £8.6k over the year. which resulted in an
overall deficit of £6.7k. It should however be noted thai as Little Acorns continued lo receive its
Education Grani for the year. we were advised ihai we could only claim JRS payments for (he
proportion of staff costs covered by non-grant incolne. hence the much lower JRS income for Little
Acorns. The Trustees continue to monitor ihe Little Acorns situation lo endeavour lo return it to a
surplus so thai the restricted fund reserve Can be increased io the Icvel required by the Association's
reserves policy.
Whilst not all the income for Litde Acorns come5 in the fO￿n of education granis which means such
income should be designated as restricted funding. the TTUStees have agreed lo treat all their income
as if it was re5trirted income. The Association treats all rcmaining income and expenditUTe as
unrestricted funds.
The Trustees continu¢ to moniior risks for ihc Associatiorl and have a Risk Register that is reviewed
annually. The Risk RegI￿er is used to infoTrn its decision regarding rescrves.
4.3.1 The Asso¢iation's Resetve Policy is to have a General Reserve Fund, plus designated reserve fvnds
known as its Closure Fund and Major Repairs Fund. In respect of its Closure Fund the trllstees have
set il at 3 months no￿al trading plus the cost of makin8 stsff redundanl. In determining the level of
the Major Repairs Fund the Trustees. in March 2018 agreed that it would comprise two elements.
the first a contingency sum to cover the COH of unforeseen major repairs (under its lease the
A$5￿]atIOn is responsible lo foT non-structurdl internal repairs which includes items such as the
hcaiing system) plus the cosl of any planned improvements to be carried during the following
financial year.
4.3.2 Th¢ ASS￿la110￿.5 Reserve Policy in respect of Littl¢ Acorns is lo have a General Restricted Reserve

Fund. of a nominal sum value plus a Closure Restricied Fund, the latter being based on the same
riteria used for Ihe Association'5 Closure Fund. This policy indicalcs the need for a fund of £27k,
whereas the iolal reserve5 of ilKir re5trictcd funds at the 31 March 2021 stood al £9.Sk. The
ditTerence in the amounts mean5 Ihai the deficil of £17.5k. if necded. will be met from the
Associalions general funds_ Thi5 a150 means that their General Reslricled reserve stand5 at L l -.
4.3.3 ' The leve15 of ihese reserves are detailed in Seciion Bl of the accounts contain¢d within this report.
4.4
Ai the dale of the approval of Ihis reW there are no uncertainti¢s abo￿ ihe charity's ability 10
continue as a goin8 concern.
STRUCTURE GOVERNANCE AliD MANAGEMENT
Governing d￿￿[￿ent
Thc chaTiIy 15 conlrolled by its 8overning documenl (its Constitulion. which is based on the
Communiiy Matters template for CIO'S) and con5titul¢s a Charitable Incorpordted Or8anisation.
The charity is governed by a Management Committee which comprises of trustees ele¢ted at the
Annual Generdl Meeting from amongst its members. In addition. Da¢orum Borough Council is
enliiled to appoint two INstees to the Management Committee.
REFERENCE AND ADMINisfRATIVE D￿Alls
The charity 15 registered as Boxm¢y)r and Warners End Neighbourhood A551xialion. In addition to
managing the Warners End Community Centre to serve the needs of its area of benefit the
Association also runs an OFSTED registered Pre-school known as Litile Acorns Pre-school.
Regisiercd Charity numlKT 15 1165570 with the Charity Comrnission for En8land and Wales.
Principal athiress
Warners End Communily Cent
Stoneycroft
Hemcl He￿p￿ead
Hertfordshire
HP13
Trustees
6.4.1 The following served as t￿￿1¢¢$ for th¢ Teporting peri(MJ. with the exceplion of Ian tAidlaw-Dickson
who resigned in Ma￿h 2021. were tTUSlees of A55(Kiation at the dale of approval of this retx)rt:
Angela Anlrobu5, Margaret Coxa8e (Chair). Ron Coxagc (Trcasurer). Alan Dickson, Graham Elliol
(Vice Chair and DBC nominee). Fiona Guesi. lan Laidlaw-Di¢kson OBE (Secrclary). John Whltman
(DBC nominee} and Yvonne Potlinger.
Ind¢pcnd¢nl examiner
Hi¢k5 and Company
Chartertxl Accountants
Vaughan Chambers
Vaughan Road
Ha￿en
Herifordshir¢
AL5 4EE
EXEMPTIONS FROM DISCLOSURE
The charity does nol have any exemwions disclosure.

FUNDS HELD AS CUSTODIAN TRusfEE ON BEHALF OF OTHERS
This charity does nol hold any fuTKls on behalfof others.
Approved by order of ihe knrd of trnsiees on 3 May 2022 and Signed on its behalf by:
Chair and TTUSlee

Boxmoor and Warners End Neighbourhood A$5ociation
Indepemden¢ Examlners Report to The Tr¥stees ofBox)noor *nd W*rThers End Neighbourhood
Associ*tio
I report on the accounts of Boxmoor and Warners End Neighlx)uho(Ml Asso¢ialion foT ihe period ended 31
Mar¢h 2021 which CQTnPTi5e ihe i￿Orne and eX￿](Ure account, balance sheet and relaled notes.
This report is made solely ¢0 the tTUStees in accordance with Sections 145 of the Chariti¢s Act. My work
has been undertaken 50 that I mighi slate lo ihe charity'5 trustees those matters l am requir￿ to State lo
Ihem in an Independent Examiner's report and for no other purpox. To ihe fullest extent permitted by
law. I do not accepl or assume Tesponsibility to anyone other than the clwity and the charity's trustees for
my ¢xamination work.
Respectlve responsibilitrs of trustees and ex*miner
The charily's trustees are responsible for the prepatatlon of the ￿COUnts. The charity's trustees consider
that an audit is not required for this year UJ]der section 144(2) of the Charities Act 2011 {the 2011 Act)
and that an independent exaMIn￿10n is needed.
li 15 my responsibility to-
examine the accounts U￿￿T section 145 of the Act"
lo follow the procedures laid dowTh in the General Directions given by the ChaTity Commission
under section 145(51(b) of the chaTities A¢t' and
to state whether particular matters have ￿me to my anenlii)n.
Basis of independent ex¥miners report
My examination was caTried oul in ￿e0rda1￿C with ihe Generdl DiTwtions given by ihe Charily
Commission¢T. An examination includes a review of the accouniing ￿CordS kepl by the charity and a
comparison of the account5 presented with those re￿rds. It a150 include5 C1)￿lderatIOn of any unusual
items or disclosures in the ac¢ounts. and the seeking of explanattons from you as trnMees concerning any
such matters. The pr￿edUreS undertaken do not provide all th¢ evidence ihat would be required in an
audit an￿ consequently no opinion is gtve as io whdher the accounts present a 'lrue and fair view. and
th¢ T¢PQrt is limited lo ihis matters set out in ihe statement below.
Independent exgn)iner'$ statement
In ¢onn¢ction with my examination. no matter has c(on¢ lo my aiienli(m:
which gives me reasonable cause to believe ihat. in any mal¢rial Rspect. the requirements:
(a)
io keep accounting iecor(Ls in accordance with seciion 130 of the ¢haTili¢s ACL
and
to prepare accounts which accord with the accounting records and to comply with
the accounting ￿qUIrements of the charities Act have not been met; or
to Whic￿ in my opinion, attention shwld be drawn in order lo enable a proper understanding of
the accounts to b¢ ¥ea¢hed.
(b)
Nick Aikman
Hicks Chartered Accountants
83 High Street
Hemel Hempstead
Hertfordshlre
HPI 3AH
Date 5 May 2022


**Boxmoor And Warners End Neighbourhood 1165570 Association Receipts and payments accounts** 

**CC16a** 

||**For the period**<br>**from**|01/04/2020<br>Period start date|**To**|31/03/2021<br>Period end date||
|---|---|---|---|---|---|



## **Section A Receipts and payments** 

|**A1 Receipts**|**BWENA**<br>**to the nearest      £**<br>**25**<br>**365**<br>**600**<br>**7,059**<br>**38**<br>**13,984**<br>**2**<br>**27,000**<br>**11,511**|**BWENA**<br>**to the nearest      £**<br>**25**<br>**365**<br>**600**<br>**7,059**<br>**38**<br>**13,984**<br>**2**<br>**27,000**<br>**11,511**|**Little Acorns**<br>**to the nearest £**<br>**216**<br>**61,185**<br>**23**<br>**3,750**<br>**3,550**|**Little Acorns**<br>**to the nearest £**<br>**216**<br>**61,185**<br>**23**<br>**3,750**<br>**3,550**|**Endowment**<br>**funds**<br>**to the nearest £**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**|**Total funds**<br>**to the nearest £**<br>**241**<br>**61,185**<br>**365**<br>**0**<br>**0**<br>**600**<br>**0**<br>**0**<br>**7,059**<br>**0**<br>**0**<br>**61**<br>**0**<br>**0**<br>**13,984**<br>**2**<br>**3,750**<br>**0**<br>**27,000**<br>**15,061**|**Total funds**<br>**to the nearest £**<br>**241**<br>**61,185**<br>**365**<br>**0**<br>**0**<br>**600**<br>**0**<br>**0**<br>**7,059**<br>**0**<br>**0**<br>**61**<br>**0**<br>**0**<br>**13,984**<br>**2**<br>**3,750**<br>**0**<br>**27,000**<br>**15,061**|**Last year**<br>**Predecessor**<br>**charity**<br>**to the nearest £**|
|---|---|---|---|---|---|---|---|---|
|Donations and fundraising|**25**||**216**|||**241**||**1,258**|
|Grants|||**61,185**|||**61,185**||**59,689**|
|Bingo|**365**|||||**365**||**2,342**|
|Canteen||||||**0**||**0**|
|Copier & Private telephone||||||**0**||**50**|
|Damage deposits|**600**|||||**600**||**5,850**|
|DCFL office recharge||||||**0**||**3,181**|
|Early yearspupilpremium||||||**0**||**0**|
|Hall hire|**7,059**|||||**7,059**||**52,308**|
|Insurancepremium refund||||||**0**||**0**|
|HMRC refunds||||||**0**||**0**|
|Interest received|**38**||**23**|||**61**||**207**|
|Lunch club receipts||||||**0**||**0**|
|Other income||||||**0**||**0**|
|Preschool charges|**13,984**|||||**13,984**||**16,621**|
|Refund of bank cahrges|**2**|||||**2**||**0**|
|Under 3year old fees|||**3,750**|||**3,750**||**9,581**|
|Utilitycharges refunds||||||**0**||**0**|
|Covid - 19 Business Supportgrant|**27,000**|||||**27,000**||**0**|
|HMRC JRSgrants|**11,511**||**3,550**|||**15,061**||**0**|
|**_Sub total_**_(Gross income for_<br>_AR)_|<br> <br>**60,583**||**68,724**||**0**|**129,307**||**151,086**|
||**0**<br>**0**||**0**<br>**0**||**0**<br>**0**|**0**<br>**0**|||
|**A2 Asset and investment sales,**<br>**(see table).**|||||||||
||**0**||**0**|||**0**|||
||**0**||**0**|||**0**||**0**|
|**_Sub total_**|<br>**0**||**0**||**0**|**0**||**0**|
|**_Total receipts_**<br>**A3 Payments**|||||||||
||**60,583**||**68,724**||**0**|**129,307**||**159,896**|
||**35,137**<br>**552**<br>**70**<br>**50**<br>**2**<br>**6,000**<br>**1,100**<br>**429**<br>**5,326**<br>**327**<br>**1,950**<br>**2,075**<br>**5,457**||**57,328**<br>**480**<br>**73**<br>**35**<br>**66**<br>**2,594**<br>**491**<br>**1,678**<br>**789**<br>**663**<br>**10,838**<br>**3,146**<br>**325**||**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**<br>**0**|**92,465**<br>**1,032**<br>**144**<br>**50**<br>**2**<br>**6,000**<br>**0**<br>**1,100**<br>**464**<br>**0**<br>**66**<br>**0**<br>**0**<br>**0**<br>**0**<br>**7,920**<br>**0**<br>**0**<br>**818**<br>**0**<br>**3,628**<br>**2,865**<br>**663**<br>**0**<br>**0**<br>**10,838**<br>**3,146**<br>**0**<br>**0**<br>**325**<br>**0**<br>**5,457**<br>**0**<br>**0**|||
|Salaries & wages|**35,137**||**57,328**|||**92,465**||**92,542**|
|Accountancy|**552**||**480**|||**1,032**||**965**|
|Bank charges|**70**||**73**|||**144**||**132**|
|Bingo|**50**|||||**50**||**657**|
|Canteen|**2**|||||**2**||**127**|
|Compensation|**6,000**|||||**6,000**||**0**|
|DAF expenditure||||||**0**||**153**|
|Damage deposit refunds|**1,100**|||||**1,100**||**5,662**|
|Dues & subscriptions|**429**||**35**|||**464**||**295**|
|Early yeraspupilpremium expenditure||||||**0**||**369**|
|Equipment|||**66**|||**66**||**3,063**|
|Fundraising||||||**0**||**292**|
|Pre-School fund raisingexpenditure||||||**0**||**0**|
|Trainingexpenditure||||||**0**||**241**|
|Grant refunds||||||**0**||**-1,841**|
|Hall repairs & maintenance|**5,326**||**2,594**|||**7,920**||**54,888**|
|Hospitality||||||**0**||**580**|
|IDACI Expenditure||||||**0**||**208**|
|Insurances|**327**||**491**|||**818**||**1,163**|
|Legal||||||**0**||**0**|
|Administration|**1,950**||**1,678**|||**3,628**||**5,772**|
|Otherprofessional services|**2,075**||**789**|||**2,865**||**0**|
|Other teachingcosts|||**663**|||**663**||**179**|
|Overheads||||||**0**||**0**|
|Lunch club expenditure||||||**0**||**3**|
|Preschool rentpayments|||**10,838**|||**10,838**||**12,269**|
|Preschool facilitycharge expenditure|||**3,146**|||**3,146**||**2,820**|
|Purchases||||||**0**||**0**|
|Refund of hall hire fees||||||**0**||**0**|
|Staff training|||**325**|||**325**||**518**|
|Sundryexpenses||||||**0**||**22**|
|Utilitycharges|**5,457**|||||**5,457**||**7,122**|
|Welfare||||||**0**||**3**|
|||||||**0**||**0**|
|**_Sub total_**|**58,475**||**78,506**||**0**|**136,981**||**188,201**|



**A4 Asset and investment purchases, (see table)** 



||**0**|<br>|**0**|<br>|**0**<br>**0**|**0**|<br>||
|---|---|---|---|---|---|---|---|---|
||**0**||**0**|||**0**|||
|**_Sub total_**|**0**||**0**||**0**|**0**||**0**|
|**_Total payments_**<br>**_Net of receipts/(payments)_**<br>**A5 Transfers between funds**<br>**A6 Cash funds last year end**<br>**_Cash funds this year end_**|||||||||
||**58,475**||**78,506**||**0**|**136,981**||**188,201**|
||||||||||
||**2,108**||**-9,782**||**0**|**-7,674**||**-28,306**|
||**0**|<br>|**0**|<br>|**0**<br>**0**|**0**|<br>|**0**|
||**0**||**0**|||**0**||**0**|
||**2,108**||**-9,782**||**0**|**-7,674**||**-28,306**|



## **Section B Statement of assets and liabilities at the end of the period** 

|**Categories**<br>Signed by one or two trustees on<br>behalf of all the trustees<br>**B1 Cash funds**<br>**B2 Other monetary assets**<br>**B4 Assets retained for the**<br>**charity’s own use**<br>**B5 Liabilities**<br>**B3 Investment assets**|Signature<br>Cash at bank and in hand<br>**Details**<br>**_Total cash funds_**<br>(agree balances with receipts and payments<br>account(s))<br>**Details**<br>**Details**<br>**Details**<br>**Details**<br>Fixtures & Fittings|**BWENA**<br>**to nearest £**<br>**73,883**<br>**0**<br>**0**|**Little Acorns**<br>**to nearest £**<br>**16,110**<br>**0**<br>**0**|**Little Acorns**<br>**to nearest £**<br>**16,110**<br>**0**<br>**0**|**Endowment**<br>**funds**<br>**to nearest £**|
|---|---|---|---|---|---|
||||**16,110**||**0**|
||||**0**||**0**|
||||**0**||**0**|
|||**73,883**|**16,110**||**0**|
|||Agreement Error<br>Agreement Error<br>**Unrestricted**<br>**funds**<br>**Restricted**<br>**funds**<br>**to nearest £**<br>**to nearest £**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**Fund to which**<br>**asset belongs**<br>**Cost (optional)**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**Fund to which**<br>**asset belongs**<br>**Cost (optional)**<br>Unrestricted<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**Fund to which**<br>**liability relates**<br>**Amount due**<br>**(optional)**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>**0.00**<br>Print Name|||OK|
||||||**Endowment**<br>**funds**<br>**to nearest £**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**Current value**<br>**(optional)**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**Current value**<br>**(optional)**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**0.00**|
||||||**When due**<br>**(optional)**|
|||||||
|||||||
|||||||
|||||||
|||||||
|||||||
||||||Date of<br>approval|
|||||||
|||||||





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