Form Fs - Mississippi Secretary Of State Annual Financial Report Form printable pdf download

Form Fs - Mississippi Secretary Of State Annual Financial Report Form

FORM FS

MISSISSIPPI SECRETARY OF STATE

ANNUAL FINANCIAL REPORT FORM

____ Initial

____Final Report

____ Renewal

NAME OF ORGANIZATION

MISSISSIPPI REGISTRATION #

___________________________________________________________________________________________________________

CHARITY CONTACT PERSON:

PERSON COMPLETING FORM:

FORM FS must be completed and be in agreement with financial information reported on IRS Form 990 or

the filed financial statement.

FORM COMPLETED USING:

_______ IRS 990

_______ FINANCIAL STATEMENT

FISCAL YEAR END

________________________

RECEIPTS AND INCOME

CONTRIBUTIONS (LIST SEPARATELY FOR EACH PROJECT OR SOURCE)

1.____________________________________________ $__________________

2.____________________________________________ __________________

3.____________________________________________ __________________

4.____________________________________________ __________________

SUBTOTAL CONTRIBUTIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . $_________________

OTHER INCOME (MEMBERSHIP DUES, ENDOWMENTS, ETC.)

1.____________________________________________ $_________________

2.____________________________________________ _________________

3.____________________________________________ __________________

SUBTOTAL OTHER INCOME . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_________________

TOTAL RECEIPTS AND INCOME:

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $____________________

Form Fs - Mississippi Secretary Of State Annual Financial Report Form