Monthly Statement Of Receipts & Disbursements
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1Monthly Statement of Receipts & Disbursements
CLUB NAME: ____________________________________________________________________CLUB NUMBER:____________________________
For the month of ____________________, 20 _____ and cumulative from ____________________, 20 _____
Budget
Receipts
Receipts
Budget
Current Month
From Beginning
Balance
Year to Date
Cash Receipts (Income)
1. Membership Fees . . . . . . . . . . . . . . . .
$ ________________
$ ________________
$ ________________
$ ________________
2. Membership Dues . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
3. Meals . . . . . . . . . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
4. Miscellaneous . . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
Fundraising
5. ______________________ . . . . . . . . . . .
__________________
__________________
__________________
________________
6. ______________________ . . . . . . . . . . .
__________________
__________________
__________________
________________
7 . ______________________ . . . . . . . . . . .
__________________
__________________
__________________
________________
8. ______________________ . . . . . . . . . . .
__________________
__________________
__________________
________________
Budget Total & Budget
Balance Total . . . . . . . . . . . . . . . . . . .
$ ______________
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ ______________
Total Receipts (Income) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ ______________
$ ______________
Budget
Disbursements
Disbursements
Budget
This Month
Year to Date
Cash Disbursements (Expenses)
1. A. International Dues . . . . . . . . . . . . .
$ ________________
$ ________________
$ ________________
$ ________________
B. Insurance Premium . . . . . . . . . . . . .
__________________
__________________
__________________
________________
2. District Dues . . . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
3. Processing Fees . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
4. Supplies . . . . . . . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
5. Printing & Stationery . . . . . . . . . . . . .
__________________
__________________
__________________
________________
6. Petty Cash . . . . . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
7 . ______________________ . . . . . . . . . . .
__________________
__________________
__________________
________________
8. ______________________ . . . . . . . . . . .
__________________
__________________
__________________
________________
9. Postage . . . . . . . . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
10. Club Bulletin . . . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
1 1. Meals . . . . . . . . . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
12. Youth Activities &
Community Service . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
13. Convention Delegates . . . . . . . . . . . . .
__________________
__________________
__________________
________________
14. Insurance & Bonds . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
15. Fellowship & Hospitality . . . . . . . . . . .
__________________
__________________
__________________
________________
16. Miscellaneous . . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
17 . Contingencies . . . . . . . . . . . . . . . . . . .
__________________
__________________
__________________
________________
Budget Total &
Budget Balance Total . . . . . . . . . . . .
$ ______________ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ ______________
Total Disbursements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ ______________
$ ______________
Excess Receipts
Over Disbursements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ ______________
$ ______________
Bank and Cash Balance, Beginning of month
. . . . . . . . . . . . . . . . .$
Bank and Cash Balance, Beginning of year
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
Bank and Cash Balance Now
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$ ______________
Dues Uncollected . . . . . . . . . . . . . . . . . . . . . . . . . .$ ________________
Miscellaneous uncollected . . . . . . . . . . . . . . . . . . .$ ________________
Bills Unpaid . . . . . . . . . .$ ________________
Total Uncollected . . . . . . . . . . . . . . . . . . .$ ______________
Submitted by _________________________________________, Secretary-Treasurer___________________________________________
NCB1006
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