


||||||~<br>~||~<br>~|~|~ ~||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|||||||Unrestricted||Restricted|||Endowment||
|||Categories||Details||funds<br>to nearest B||funds<br>to naareet||B|funds<br>to nearest B||
|81 Cash||funds||Bank|||13221||||||
||||||Total cash funds||13221||||||
|||||(agree|balances ettb receipts and payments<br>account(s))|Oa<br>Unrestricted||(IX<br>Restricted|||Ot(<br>Endowment||
|||||||funds|||funds|||funds|
|||||Details||to nearest B||to|nearest|E|to nearest S||
|82 Other||monetary assets|||||||||||
|||||Details||Fund <br>asset|to whish<br> baton s|Cost (optional)|||Current value<br>o tional||
|83Investment|||assets||||||||||
|||||Details||Fund <br>asset|to which<br> baton<br>s|0|t(<br>H|n t)|Currentvalue<br>o Honal||
|84Assets retained for the|||||||||||||
|charity's||own|use||||||||||
|||||||Fund|to which|Amount||due||When due|
|||||Details||Ilabll|relates||o tlonal|||o tional|
|85 Liabilities|||||||||||||
|Signed<br>behalf|by one or two trustees on<br> ofaa the trustees||||Signature||Print Name|||||Date of<br>s<br>roval|
|||||||A'|tku~ CA|||||6/GZ|



