Form Wv/raf-3 - Annual, Limited And State Fair Raffle Financial Report Page 2
Download a blank fillable Form Wv/raf-3 - Annual, Limited And State Fair Raffle Financial Report in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Wv/raf-3 - Annual, Limited And State Fair Raffle Financial Report with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4WV/RAF-3
ANNUAL, LIMITED & STATE FAIR RAFFLE FINANCIAL REPORT
rtL179 v 10-Web
PLEASE USE BLUE OR BLACK INK ON ALL FORMS
SCHEDULE A - GROSS PROCEEDS
1.
Sale of Raffle Tickets
.
2.
Donated Prizes (Value)
.
3.
Other Proceeds
.
4.
Total Gross Proceeds (Add lines 1 through 3) Enter here and on Page 1 Line 1
.
SCHEDULE B - PRIZE PAYOUTS
1.
Cash or Check
.
2.
Merchandise (Value)
.
3.
Donated Prizes (Value)
.
4.
Door Prizes
.
5.
Total All Prizes (Add Lines 1 Through 4) Enter here and on Page 1 Line 2
.
SCHEDULE C - RAFFLE EXPENSES
1.
Rental
.
2.
Salaries & Related Payroll Taxes
.
3.
Bad Checks
.
4.
Utilities
.
5.
Raffle Games
.
6.
Custodial, Security, Personnel, Child
.
7.
Maintenance & Repairs
.
8.
Other (License Fee, Etc…)
.
9.
Total Expenses (Add Lines 1 Through 8) Enter here and on Page 1 Line 3
.
AGREEMENT
THE FINANCIAL RETURN MUST BE CERTIFIED BY A CERTIFIED PUBLIC ACCOUNTANT OR BY A LICENSED PUBLIC ACCOUNTANT
IF SCHEDULE A LINE 4 (TOTAL GROSS RECEIPTS) EXCEEDS $50,000
, AS AN AUTHORIZED REPRESENTATIVE OF
I,
CERTIFY OR AFFIRM THAT THE STATEMENTS AND ITEMS ENTERED HEREIN AND ATTACHED HERETO ARE TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE
(Name - Type or Print)
(Signature)
(Date)
(Telephone Number)
(Email Address)
O
1
7
0
8
0
9
0
2
W
Page 2 of 4
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial