Form Fs - Mississippi Secretary Of State Annual Financial Report Form Page 2
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42.
EXPENSES –
1.
PROGRAM SERVICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$_____________________
ITEMIZE BY CATEGORY THE
AMOUNT DISBURSED
FOR EACH MAJOR PURPOSE:
PUBLIC EDUCATION
$__________________
_________________________________ $__________________
_________________________________ $__________________
2. ADMINISTRATION (MANAGEMENT & GENERAL) . . . . . . . .
$_____________________
3. FUNDRAISING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$_____________________
4. PAYMENTS TO AFFILIATES . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$_____________________
5. OTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
$_____________________
TOTAL EXPENSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$___________________
List joint costs reported in Program Services from a combined educational campaign and fundraising solicitation:
Total Amount before allocation : _______________ Amount allocated to Program Services:
____________________
Amount allocated to Fundraising:
____________________
Amount allocated to Management & General: ____________________
I CERTIFY THAT ALL INFORMATION PROVIDED IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
___________________________________________________________
Sworn to and subscribed before me this the
SIGNATURE OF PRESIDENT OR
DATE
OTHER AUTHORIZED OFFICER
________ day of __________________________, 20____
___________________________________________________________
_______________________________________________
PRINTED OR TYPED NAME AND TITLE
NOTARY PUBLIC
NOTARY SEAL
____________________________________________________________
Sworn to and subscribed before me this the
CHIEF FINANCIAL OFFICER
DATE
_______ day of ___________________________, 20___
____________________________________________________________
PRINTED OR TYPED NAME AND TITLE
________________________________________________
NOTARY PUBLIC
NOTARY SEAL
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