Arizona Form 99 - Arizona Exempt Organization Annual Information Return

AZ Form 99 (2002) Page 2

Schedule A - Balance Sheet

(a)

(b)

Note: Amounts used in attached schedules and in this column should be end of year amounts.

Beginning of year

End of year

Assets

Cash ........................................................................................................................

A2a Accounts receivable.................................................. A2a

b Less: allowance for doubtful accounts................... A2b

c Line A2a less line A2b. Enter difference in column (b)..........................................

00 A2c

A3a Other notes and loans receivable - attach schedule.. A3a

b Less: allowance for doubtful accounts................... A3b

c Line A3a less line A3b. Enter difference in column (b)..........................................

00 A3c

Inventories ...............................................................................................................

Investments (securities) - attach schedule...............................................................

Investments (other) - attach schedule......................................................................

A7a Land, buildings, and equipment; basis ..................... A7a

b Less: accumulated depreciation - attach schedule A7b

c Line A7a less line A7b. Enter difference in column (b)..........................................

00 A7c

Other assets - describe _____________________________________________

Total assets - add lines A1 through A8................................................................

____________________________________________________________________________________________________________________________________________________

Liabilities

A10 Accounts payable and accrued expenses ...............................................................

00 A10

A11 Mortgages and other notes payable - attach schedule............................................

00 A11

A12 Other liabilities - describe.........................................................................................

00 A12

A13 Total liabilities - add lines A10 through A12........................................................

00 A13

____________________________________________________________________________________________________________________________________________________

Net Assets

A14 Capital stock or trust principal..................................................................................

00 A14

A15 Paid-in or capital surplus..........................................................................................

00 A15

A16 Retained earnings or accumulated income..............................................................

00 A16

A17 Total net assets - add lines A14 through A16 .....................................................

00 A17

A18 Total liabilities and net assets - add lines A13 and A17.....................................

00 A18

____________________________________________________________________________________________________________________________________________________

Certiﬁ cation

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and

belief, it is a true, correct and complete return, made in good faith, for the taxable year stated pursuant to the income tax laws of the State of Arizona.

Please

_______________________________________________________________________________________________________________________________

Sign Here

Signature of ofﬁ cer

Date

Title

____________________________________________________________________________________________________________________________________________________

Paid

Preparer’s

___________________________________________________________________________________________________________________________________

Preparer’s signature

Date

Use Only

________________________________________________________________________________________________________________________

Firm’s name (or preparer’s, if self-employed)

Preparer’s TIN

___________________________________________________________________________________________________________________________________

Firm’s address

Zip code

____________________________________________________________________________________________________________________________________________________

ADOR 91-0022 (02)

Arizona Form 99 - Arizona Exempt Organization Annual Information Return - 2002 Page 2

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