Form 308 - Charitable Organization Annual Report
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4Wisconsin Department of Safety and Professional Services
Mail To:
P.O. Box 8935
1400 E. Washington Avenue
Madison, WI 53708-8935
Madison, WI 53703
FAX #:
(608) 261-7083
E-Mail: web@dsps.wi.gov
Phone #:
(608) 266-2112
Website:
DIVISION OF PROFESSIONAL CREDENTIAL PROCESSING
CHARITABLE ORGANIZATION ANNUAL REPORT
ACCOUNTING PERIOD DATE
Beginning __________
Ending __________
THIS FORM REQUIRES 2 DIFFERENT SIGNATURES.
PLEASE TYPE OR PRINT IN INK
NAME OF ORGANIZATION
WISCONSIN REGISTRATION NUMBER
ADDRESS (NUMBER AND STREET) OR P.O. BOX
FEDERAL EMPLOYER I.D. NUMBER
CITY OR TOWN, STATE, ZIP CODE
ORGANIZATION’S DAYTIME PHONE
NUMBER
(
)
INDICATE ORGANIZATION TYPE
ACCOUNTING METHOD
___ Cash
___ Civic & Social Action
___ Health Services
___ Culture
___ Other (Specify)
___ Accrual
___ Education & Research
___ Human Services
___ Other
PART I
STATEMENT OF REVENUE
TOTAL
1.
Contribution, gifts, grants & similar amounts received
a.
Direct public support ................................................................................
1a
b.
Indirect public support ..............................................................................
1b
c.
Total Public Support (add lines 1a and 1b) ..................................................................................................
1c
2.
Government grants ..............................................................................................................................................
2
3.
Program service revenue ......................................................................................................................................
3
4.
Membership dues and assessments .......................................................................................................................
4
5.
Interest on savings and temporary cash investments ...........................................................................................
5
6.
Dividends and interest from securities .................................................................................................................
6
7.
a.
Gross rent ..................................................................................................
7a
b.
Less: rental expenses ...............................................................................
7b
c.
Net rental income (loss) (line 7a less line 7b) ..............................................................................................
7c
8.
Other investment income (attach schedule) .........................................................................................................
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9.
Capital gains:
a.
Gross amount from sales of assets other than inventory ...........................
9a
b.
Less: cost or other basis and sales expenses ............................................
9b
c.
Gain (loss) (line 9a less line 9b) (attach schedule) ......................................................................................
9c
10. Special fund-raising events and activities (attach schedule)
a.
Gross revenue (not including $__________________) of
contributions reported on line 1a ..............................................................
10a
b.
Less: direct expenses ...............................................................................
10b
c.
Net income (line 10a less line 10b) ..............................................................................................................
10c
11. a.
Gross sales less returns and allowances ....................................................
11a
b.
Less: cost of goods sold ...........................................................................
11b
c.
Gross profit (loss) line 11a less line 11b) (attach schedule) .......................................................................
11c
12. Other Revenue (attach schedule) .........................................................................................................................
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13. Total Revenue (add lines 1c, 2, 3, 4, 5, 6, 7c, 8, 9c, 10c, 11c and 12) .................................................................
13
#308 (Rev. 11/11)
Ch. 440, Stats.
Page 1 of 4
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