Form Char-497 - Annual Financial Report Page 2
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4SCHEDULE 1: CONTRIBUTIONS
NOTE: Do not report donated services or facilities in this schedule.
TOTAL
Portion other
AMOUNT
than cash
Direct Public Support
1. Direct mail . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Telephone solicitation campaigns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Commercial co-venturers (complete Schedule 4) . . . . . . . . . . . . . . . . . . . .
4. Door-to-Door . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5. Special events (contribution portion only) . . . . . . . . . . . . . . . . . . . . . . . .
6. Telethon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7. Other (specify):
8.
9.
10. Total general public support (add lines 1 through 9) . . . . . . . . . . . . . . . . . . .
11. Foundation and trust grants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Corporate and other business grants . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13. Legacies and bequests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14. Total direct public support (add lines 10 through 13) . . . . . . . . . . . . . . . . . . .
(Transfer total line 14 to page 1, line 1.)
Indirect Public Support
15. From Federated Fund Raising Agencies . . . . . . . . . . . . . . . . . . . . . . . . . .
16. From affiliates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17. From other fund raising agencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18. Total indirect public support (add lines 15 through 17). . . . . . . . . . . . . . . . .
(Transfer total line 18 to page 1, line 2.)
Government Grants
19. Specify Agency:
(a)
(b)
(c)
(d)
(e) All other government grants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20. Total government grants (add lines 19(a) through 19(e)) . . . . . . . . . . . . . . . .
(Transfer total line 20 to page 1, line 3.)
21. Total contributions (sum of lines 14, 18 and 20) . . . . . . . . . . . . . . . . . . . . .
ACTIVITY STATEMENTS
G YES* G NO
1. Have your books/records been audited by or for any government agency/funding source this fiscal year?
*If YES, specify agency:
Period audited:
2. Does your organization allocate costs of multipurpose activities among program services, management
G YES* G NO
and general, and fund raising; i.e., Direct Mail, Telethon?
*If YES, See INSTRUCTIONS: Reporting Joint Costs of Multi-Purpose Activities.
3. Did your organization receive donated services or the use of materials, equipment or facilities at no
G YES* G NO
charge or at substantially less than fair rental value?
*If YES, indicate the value:
Do not include this amount as support or as an expense on page 1.
CHAR497 2\99
PAGE 2
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Parent category: Business