





|~|w||||s|~|~|~|~|~|~ ~|||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|||||||||Unrestricted||Restricted|||Endowment|
|||||||||funds<br>to nearest|f|to|funds<br> nearestt||funds<br>to nearest t|
|Bt Cash|funds|||Bank Current Account||||||||||
|||||Ceposit Account||||||||||
||||||Total||cash funds|||||||
|||||(agree balances|with|receipts snd paymenta||||||||
||||||||acccuhl(s))|||||||
|||||||||Unrestricted||Restricted|||Endowment|
|||||Details||||funds<br>to nearest|f|to|funds<br> nearest f||funds<br>to nearest t|
|82 Other monetary assets||||||||||||||
|||||Details||||Fund to which<br>asset helen<br>s||Cost (optional)|||Current value<br>o tlonsl|
|BSInvestment||assets||||||||||||
|||||Details||||Fund to which<br>asset balan s||Co|t(o tio|1)|Currentvalue<br>o tional|
|B4Assets retained for|||the|||||||||||
|charity's|own|use||||||||||||
|||||||||Fund to which||Amount due|||When dus|
|||||L)ctalls||||il|||nsl||o tional|
|BSLiabilities||||||||||||||
|Signed by one or <br>behalfofallthetr||two trustees<br>ustees|on|Signet,|||e||Print|Name|||Date of<br>a<br>revel|



