United States Conference of Catholic Bishops Financial Records Retention Schedule. (Adopted by the Catholic Diocese of Charlotte, January 1, 2007)

Transcription

1 Appendix A, page 1 of 3 United States Conference of Catholic Bishops Financial Records Retention Schedule (Adopted by the Catholic Diocese of Charlotte, January 1, 27) Bank deposits Bank statements Cancelled checks Check registers/stubs Type of Records Banking Retention Period General Audit reports Balance sheets, annual Balance sheets, monthly/quarterly Budgets, approved, revised Financial reports, annual Financial reports, monthly Financial statements Permanent Permanent Destroy after 1 year Permanent Destroy after 1 year Permanent Investment/Insurance Bonds, canceled Certificates of deposit, cancelled Insurance policies/active Insurance policies/cancelled Letters of credit Mortgage records Securities sales Stock investment from date of cancellation 3 years after redemption Permanent Permanent Permanent after sale

2 Appendix A, page 2 of 3 USCCB Financial Records Retention Schedule (cont.) Type of R ecords Retention Period Accounting Accounts payable invoices Accounts payable ledgers Accounts receivable ledgers Credit card statements/charge slips Invoices and paid bills, major building construction Invoices and paid bills, general accts Cash books Cash journals Cash journal, receipts on offerings and pledges Receipts Mortgage payments Permanent Other Records General ledger/annual Permanent Journals, general and specific funds Permanent Journal entry sheets Ledgers, subsidiary Payroll journals Payroll registers, summary schedule of earnings, deductions and accrued leave Pension records Permanent Pledge registers/ledgers Permanently restricted gift documents Permanent Temporarily restricted gift documents after meeting restrictions

3 Appendix A, page 3 of 3 USCCB Financial Records Retention Schedule (cont.) Type of R ecords Retention Period Tax Records Employment taxes, contributions, and payments, including taxes from date of filing withheld, FICA W 2 forms from date of filing W 4 forms from date of filing IRS exemption determination letters, for organizations other Permanent than those listed in The Official Catholic Directory Form 99 Permanent State tax exemption certificates (income, excise, property, Permanent sales/use, etc.)

4 Appendix B (Parish) Cash Receipts Journal for the Period: Account Description Envelopes Loose Total Checks Cash Checks Cash Offertory Sacramental Offerings Special Purpose Collection Donations, General Fundraising Activity Fee Religious Formation Other Income Exempt Capital Fund Capital/Facilities Fund, General Debt Reduction Collection Custodial Obligations Other Count Totals Count Team Signatures: Deposit Summary: Currency Coins Checks Today's Date Total Deposit* $25 or more in a single contribution? *Must cross balance with Count Total Revised January 212

5 Appendix C ROMAN CATHOLIC DIOCESE OF CHARLOTTE STOCK DONATION INSTRUCTIONS Gifts of stock may be made via electronic transfer or by physical certificate. The Diocese of Charlotte maintains a brokerage account with Wells Fargo Advisors for the purpose of processing electronic transfers to the Diocese for the benefit of the Diocese or any of its parishes, schools or agencies. The Diocese cannot initiate stock transfers on your behalf. You must contact your broker directly. PLEASE PROVIDE ALL INFORMATION REQUESTED AND FORWARD TO: Mark Greene mtgreene@charlottediocese.org 1123 South Church Street Charlotte, NC 2823 (74) ; Fax (74) NOTICE OF STOCK DONATION: Name: Address: Parish: (Street) (City) (State) (Zip) Phone Work: Home Name of stock and shares donated: Date: How Donated: Electronically Physical Certificate Please apply my gift towards: (DSA, Name of ParishOffertory, Capital Campaign, Catholic Charities, etc.) If securities are electronically transferred, the acknowledgement date is the date the securities enter our account at Wells Fargo Advisors. For handdelivered securities to the Diocese or Wells Fargo Advisors, the acknowledgement date is the date received. If the securities are mailed to the Diocese, the acknowledgement date is the date received. Within ten days of processing your gift, an acknowledgement that complies with IRS regulations will be sent. Wells Fargo Advisors has instructions to sell stock as soon as possible (usually by the business day following their receipt of the stock). The actual net proceeds from the sale represent the amount that will be applied as you requested above. The net proceeds will be affected by the actual sale price, as well as a broker charge to process the transaction. Accordingly, there will be a variance between the charitable deduction amount and the net proceeds applied from the gift. The Diocese can not be responsible for any variance in these amounts. 1 of 2

6 Appendix C ROMAN CATHOLIC DIOCESE OF CHARLOTTE STOCK DONATION INSTRUCTIONS (page 2 of 2) A. ELECTRONIC TRANSFER BY BROKER Please communicate the following information to your broker To: (Broker s Name & Company) Please transfer shares of stock from my Account to: The Granzow Consulting Group of Wells Fargo, Advisors, LLC 6 Fairview Road, Ste 8 Charlotte, NC 2821 Phyllis Smith Direct: (74) Fax: (74) ROMAN CATHOLIC DIOCESE OF CHARLOTTE ACCOUNT # DTC # 141 I / we hereby authorize the above stock transfer: (Signature) (Date) (Signature) (Date) B: DIRECT DONATION OF CERTIFICATE 1. If certificate is titled in the name of the donor: a. Sign certificate b. Include a letter of intent with your name, address, stock and shares and intent (e.g., Diocese of Charlotte Diocesan Support Appeal, Catholic Charities, etc), with your signature and date. c. Send by registered mail (or deliver) to the Diocese or deliver to a Wells Fargo Advisors office. Do not deliver stock to a Wells Fargo Bank location. d. Send copy of the completed first page of these stock donation instructions to the Diocese. 2. If certificate is titled in the name of the Diocese: a. Send by registered mail (or deliver) to the Diocese, with the completed first page of these stock donation instructions. PLEASE SEND COPY OF PAGE 1 TO: Mark Greene mtgreene@charlottediocese.org 1123 South Church Street Charlotte, NC 2823 (74) ; Fax (74) of 2

7 Appendix D Roman Catholic Diocese of Charlotte Sample Acknowledgement for a Single Cash or Noncash Gift (Date) Name of Contributor Address of Contributor Dear : Thank you for your contribution of ($ amount of cash contribution or description of noncash contribution) to (Donee organization) on (date of contribution). Your generous sharing of your financial resources is greatly appreciated. Many of the good things that are happening in our parish community would not be possible without the good stewardship of so many of our parishioners. Thank you again for your generous support. May God bless you and your loved ones during the coming year. Donee Organization By: Title: NOTE: Pursuant to sections 17(f)(8) of the Internal Revenue Code, which addresses substantiation of charitable contributions, this is to acknowledge the fact that (donee organization) did not provide any goods or services in whole or partial consideration for the above contributions, or provided only intangible religious benefits.

8 Appendix E Roman Catholic Diocese of Charlotte Sample Acknowledgement for Annual Contributions, Including a Listing of Gifts of $25 or more (Date) Name of Contributor Address of Contributor Dear : Thank you for your contributions to (Donee organization) during the year 2xx. Your generous sharing of your financial resources is greatly appreciated. Many of the good things that are happening in our parish community would not be possible without the good stewardship of so many of our parishioners. Thank you again for your generous support. May God bless you and your loved ones during the coming year. Donee Organization By: Title: NOTE: Pursuant to sections 17(f)(8) of the Internal Revenue Code, which addresses substantiation of charitable contributions, your total contributions for 2xx were ($xxxxxxxxx). Included in that amount are the following contributions of $25 or more: $ $ $ $ Amount Date (Donee organization) did not provide any goods or services in whole or partial consideration for the above contributions, or provided only intangible religious benefits.

9 Appendix F Roman Catholic Diocese of Charlotte Sample Acknowledgement for Annual Contributions, Including Quid Pro Contributions (Date) Name of Contributor Address of Contributor Dear : Thank you for your contributions to (Donee organization) during the year 2xx. Your generous sharing of your financial resources is greatly appreciated. Many of the good things that are happening in our parish community would not be possible without the good stewardship of so many of our parishioners. Thank you again for your generous support. May God bless you and your loved ones during the coming year. Donee Organization By: Title: NOTE: Pursuant to sections 17(f)(8) and 6115 of the Internal Revenue Code, which addresses substantiation of charitable contributions, your total contributions for 2xx were ($xxxxxxxxx). Included in that amount are the following contributions of $25 or more: $ $ $ $ Amount Date (Donee organization) provided the following goods and services in return for the above contribution: The estimated value of these goods and services is $. The amount of your contribution for federal income tax purposes is limited to the excess of the amount contributed over the estimated value of the goods and services indicated above.

10 Appendix G Roman Catholic Diocese of Charlotte Sample Acknowledgement for a Single Quid Pro Contribution (Date) Name of Contributor Address of Contributor Dear : Thank you for your contribution of ($ amount of cash contribution or description of noncash contribution) to (Donee organization) on (date of contribution). Your generous sharing of your financial resources is greatly appreciated. Many of the good things that are happening in our parish community would not be possible without the good stewardship of so many of our parishioners. Pursuant to sections 17(f)(8) and 6115 of the Internal Revenue Code, this is to acknowledge the fact that (donee organization) provided the following goods and services in return for the above contribution: The estimated value of these goods and services is $. The amount of your contribution for federal income tax purposes is limited to the excess of the amount contributed over the estimated value of the goods and services indicated above. Thank you again for your generous support. May God bless you and your loved ones during the coming year. Donee Organization By: Title:

11 Roman Catholic Diocese of Charlotte Sample Acknowledgement for a Gift of a Vehicle Appendix H (Must be given to donor within 3 days of the donation; in addition, if the value of the vehicle is $5 or more, Form 198C must be furnished to the donor and filed with the Internal Revenue Service) Date Name of Donor Social Security Number of Donor Address of Donor Dear : Thank you for your contribution of (description of vehicle, including make, model, and vehicle identification number) to (Donee organization) on (date of contribution). The parish should select one of the following three paragraphs to include in the letter, depending on how the gift was used: 1. As part of our outreach ministry to the poor, (Donee organization) is providing this vehicle to an individual (family) in need of transportation, at significantly below the fair market value. We are, indeed, very grateful to you for the very generous donation of this automobile, which is directly benefiting a local family in need. 2. The vehicle will be used in the ministry of our church. We are, indeed, very grateful to you for the very generous donation of this automobile. 3. The vehicle will be sold in an arm s length transaction to an unrelated party. We are, indeed, very grateful to you for the very generous donation of this automobile. (Date of Sale) (Proceeds from Sale) Donee Organization By: Title: NOTE: Pursuant to sections 17(f)(8) of the Internal Revenue Code, which addresses substantiation of charitable contributions, this is to acknowledge the fact that (donee organization) did not provide any goods or services in whole or partial consideration for the above contributions, or provided only intangible religious benefit.

12 Name Parish Mileage Expense Report Department Appendix I Business Odometer Odometer Date Travel ToFrom Purpose Beginning Ending Total Miles Total Business Miles I certify that the above mileage was incurred in conduct of parish business..56 per Mile Employee or volunteer signature and date Supervisor signature and date

13 Parish Name Travel Expense Report Department Appendix I Date Business Purpose Expenses: Breakfast Persons included Lunch Persons included Dinner Persons included Lodging Transportation Other Include and circle amounts charged on parish credit card. For all persons for whom expenses were incurred and listed above, provide their name and title or business relationship. I certify that the above expenses were incurred in conduct of parish business. Total Expenses Above From Mileage Reimbursement Form Less Travel Advance Less Amount on Parish Card Balance Due Employee/Volunteer Employee or volunteer signature and date Supervisor signature and date Please attach all receipts

14 Short Form Reimbursement Request Appendix J Parish: Date Amount Make Check Payable to Persons covered by expenditure Account to charge Department/Commission Name of vendor/provider Business purpose of expenditure Signature of person requesting reimbursement Supervisor approval Date Approved Receipts must be attached ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Parish: Date Amount Make Check Payable to Persons covered by expenditure Account to charge Department/Commission Name of vendor/provider Business purpose of expenditure Signature of person requesting reimbursement Supervisor approval Date Approved Receipts must be attached

15 Roman Catholic Diocese of Charlotte Parish & School SemiAnnual Financial Report PARISH: CITY: REPORTING PERIOD: Appendix K, page 1 PART 1: Confirmation of Accounting System Closing for the Reporting Period 1 Surplus (Deficit) for the current sixmonth period, excluding restricted activity 2 Restricted Activity for the current sixmonth period: increase (decrease) Church School 3 Surplus (Deficit) for the current sixmonth period, including restricted activity (1 plus 2) 4 Total assets as of periodend 5 Total liabilities as of periodend 6 Total Net Assets as of periodend Please verify that Line 4 equals the sum of Lines 5 and 6 RECONCILIATION OF NET ASSETS FOR THE SIX MONTH PERIOD: 7 Total Net Assets at end of last sixmonth period per the previous periodend financial report 8 Surplus (Deficit) per current sixmonth period, as reported on Line 3 above 9 Total Net Assets at end of current period (Lines 7 plus 8) Please verify that this amount agrees to the total Net Assets reported on Line 6 above RECONCILIATION OF CASH FROM JULY 1 TO END OF REPORTING PERIOD: 1 Total Checking Account Balances per the previous yearend financial report 11 Increase (decrease) in checking accounts from July 1 to end of reporting period: for church: per the Cash Flow section of the for school: from worksheet next page* 12 Total Checking Account Balances at the end of the reporting period (Lines 1 plus 11) Please verify that this amount agrees to total checking account balances reported on current period financial report. COMPLETE 13 AND 14 AFTER CLOSING BOOKS FOR THE REPORTING PERIOD 13 Accounting for the period was complete as of (date) 14 The reporting period was closed in ConnectNow on (date) Revised January 215

16 Worksheet for Schools *calculation of change in school checking account balances from July 1 to end of reporting period: a Surplus (Deficit) for the fiscal yeartodate period b (Increase) Decrease in assets accounts(other than Checking Accounts) for the fiscal yeartodate period c Increase (Decrease) in liability account for the fiscal yeartodate period d Change in Checking Account Balances for the fiscal yeartodate period (Lines a plus b plus c) Please transfer to Line 11 above Line a equals Line 8 page 1 Line b : Total Assets Beginning of fiscal period Less: Checking Account Balance beginning of fiscal period Checking Account Balance beginning of fiscal period Checking Account Balance beginning of fiscal period Total Assets Beginning of fiscal period, less checking account balances Total Assets End of reporting period Less: Checking Account Balance end of reporting period Checking Account Balance end of reporting period Checking Account Balance end of reporting period (Increase) Decrease in assets accounts(other than Checking Accounts) for the fiscal yeartodate period Line c: Total Liabilities End of reporting period Total Liabilities Beginning of Fiscal Period Increase (Decrease) in liability account for the fiscal yeartodate period Line d : Add lines a, b, and c carries to Line 11, page 1 Revised January 215

17 Roman Catholic Diocese of Charlotte Parish & School SemiAnnual Financial Report Appendix K, page 2 Part 2: Supplemental Financial Information 1. List each auxiliary organizations checking, savings Church School Organization Account Type Bank or Diocese Account Number Balance Balance Total 2. Describe any capital/debt reduction campaign Purpose: Goal: Campaign Period: to Payment Period: to Pledge payments received during the preceding six months: Total cumulative pledge payments received for the campaign: Pledge commitments received during the preceding six months: Total cumulative pledge commitments received for the campaign: 3. List parish property which has been leased or rented during the preceding six months: Amount Amount Lessee Description of Property Rent Received Rent Received Total rental income per the Statement of Activities: 4. List all nondiocesan subsidies received during the preceding six months: Source Amount Received Amount Received Total nondiocesan subsidy income per the Statement of Activities: 5. List all vehicles: Description of Property, i.e., Make/Model, etc. Cost Cost Total amount shown as vehicles per the Statement of Financial Position 6. Any additional information or explanations of activity during the preceding six months: 7. To the best of my knowledge, the information contained in the parish financial statements and supplemental financial reports is complete and accurate. Signed (Pastor) Date Revised January 215

18 Roman Catholic Diocese of Charlotte Parish & School SemiAnnual Financial Report Appendix K, page 3 Part 3: Pastor Designated Contacts for the Diocesan System To help us keep the active directory of parish contact persons accurate, please complete the following for each of the contact positions listed below: Position: Religious Education Contact Name (First, Middle, Last): Position: Finance Contact Name (First, Middle, Last): Position: Human Resources Contact Name (First, Middle, Last): Position: Stewardship Contact Name (First, Middle, Last): We are establishing a new parish contact for the position that is responsible for handling property/liability/auto insurance claims and risk management issues, such as building security and safety, eligibility for driving on behalf of the parish, special events, etc. Please complete the following, so a diocesan account may be established in their name. Position: Properties Risk Management Contact Name (First, Middle, Last): Pastor: Telephone: Parish: Fax: Mailing Address: Revised January 215

19 Appendix L, page 1 Parish Letterhead Date: (Due sixty days following period end) Dear Bishop: Enclosed is the financial report (consisting of, but not limited to, a Statement of Financial Position and Statement of Activities) that was made available to parishioners for the six month period ending December 31, 2xxx or the fiscal year ending June 3, 2xxx. Also enclosed is the annual budget for the current fiscal year. Please accept this statement as the Parish Finance Council certification of the financial governance of the parish. This is to certify to the following: 1. that the enclosed financial report for the previous fiscal period represents, to the best of our knowledge and belief, an accurate and complete accounting of parish finances; 2. that the enclosed financial report for the previous fiscal period was made available to parishioners on (date); 3. that the enclosed annual budget for the current fiscal year was made available to parishioners on (date); 4. that, in addition to the period end report enclosed, interim financial statements (including, but not limited to, a Statement of Financial Position and Statement of Activities) were made available to parishioners during the previous six month period, as follows: Date of financial statements Date Issued to Parishioners 5. that the Parish Finance Council regularly reviews and discusses the budget and periodic financial statements. Meetings of the finance council during the previous six month period and since the end of th e six month period, were held on the following dates:

20 Appendix L, page 2 6. that I have read the current Diocese of Charlotte Financial Policy Manual, and I acknowledge my responsibility to comply with these guidelines and to contact the diocesan Finance Office if I have concerns about any aspect of parish finances that are not being appropriately addressed. The above is hereby attested to by the Pastor and the members of the Parish Finance Council. Printed Name Occupation Signature Date Sincerely yours, Pastor Date

21 Appendix M Monthly Financial Report of Auxiliary Organization Organization For the Month of Beginning Checking Account Balance $ Add: Revenues Deposited: $ Total Revenues Deposited Deduct: Expenses Paid : Total Expenses Paid Ending Checking Account Balance $ (should agree with bank reconciliation) Notes: Submitted by Date Title

22 DL Catholic, Inc. Deposit Account Agreement Terms and Conditions Appendix N, page 1 1. INTRODUCTION The DL Catholic, Inc. deposit program is only available to entities of the Roman Catholic Diocese of Charlotte. This Agreement governs your use of DL Catholic, Inc. s services. Use of services is expressly conditioned on your acceptance of this Agreement. By using the services of DL Catholic, Inc., you acknowledge that you have read and agree to abide by the terms and conditions of this Agreement. 2. DEPOSITS You may make deposits to your account with DL Catholic, Inc. by mailing a check to the Pastoral Center Finance Office, with a reference to the account number to which the funds are to be deposited. Deposits for the Investment Program must be accompanied by a deposit advice signed by an authorized signer. 3. WITHDRAWALS You may make withdrawals from your account by written notice 1 days in advance in any amount up to the balance in the account less the minimum required balance. Withdrawals from the Investment Program cannot be made until the minimum investment period of 18 months has been reached. 4. MINIMUM REQUIRED BALANCES The minimum required balance for the Savings Program is $1 and for the Investment Program is $5,. 5. TERM Funds on deposit in the Investment Program are subject to a minimum investment period of 18 months before they are eligible for withdrawal. Funds on deposit in the Savings Program are not subject to a minimum investment period. 6. AUTHORIZED SIGNATURES The parish priests are the authorized signers for parish accounts, including parish schools. The principal and superintendent of schools are authorized signers for nonparish schools. Agency directors are the authorized signers for agencies. In lieu of the above, the diocesan bishop, chancellor or chief financial officer may sign on behalf of authorized signer. DL Catholic, Inc will only honor requests from an authorized signer for withdrawals or other transactions related to your account. Requests must be in writing and must contain a handwritten signature copies, facsimiles, or signatures that appear to be made by machine or stamp, or otherwise, will not be honored. 7. STATEMENTS Your account statement(s) will be mailed or made available to you on a quarterly basis and will include the amount of interest earned, if any, for the statement period. 8. INTEREST CALCULATION/EARNINGS RATES Interest on your deposit account will be determined based on the type of account you hold. The earnings rate on savings accounts is Prime less 3.5% with a minimum annual earnings rate of.5%. The rate of return on investment accounts is Prime less 2.5% with a minimum annual earnings rate of 1.%. The prime rate is determined by Wells Fargo Bank as of the opening of the first day of the month. The rate is fixed for the calendar month. 9. OWNERSHIP OF FUNDS ON DEPOSIT Funds on deposit are held by DL Catholic, Inc. in trust for the investing entity (parish/school/agency of the Roman Catholic Diocese of Charlotte), which is the owner of the funds on deposit. Furthermore, the Canonical Pastor/Administrator duly appointed by the Roman Catholic Bishop of Charlotte is the administrator of the assets of the parish/juridic person according to the internal law and rules of the Roman Catholic Church and as contemplated by North Carolina General Statute Section 615. No funds placed with the corporation become funds of the corporation or of the Diocese of Charlotte solely by virtue of their placement, but rather retain their character as property of the placing entity whose use is restricted. * * * * * * * * * * * *

23 Appendix N, page 2 DL Catholic, Inc Investment Program DEPOSIT ADVICE Parish/School/Agency: Amount of Deposit: Check enclosed: (Y) (N) Transfer from diocesan savings program (Y) (N) I have read and agree to abide by the terms and conditions as outlined in the Deposit Account Agreement. Date: Signed: Please return with deposit to: Catholic Diocese of Charlotte Finance Office 1123 S. Church St. Charlotte, NC

24 Appendix O Parish/School/Agency BB&T Credit Card log For Card: Card CheckOut Date Card CheckIn Date Initials of Person Checking Card out Amount of Purchase GL Account Number Payments on Card Account Balance Outstanding On Card

25 Parish: CHECK CONTROL LOG Appendix P CHECKS REMOVED FR STOCK CHECKS RETURNED TO STOCK CHECKS USED & VOIDED NO. OF FROM TO FROM TO FROM TO CHECKS NO. OF DATE CHECK # CHECK # APPROVAL CHECK # CHECK # APPROVAL CHECK # CHECK # USED INVOICES BY APPROVAL

26 Appendix Q Roman Catholic Diocese of Charlotte REQUEST FOR CREDIT CARD OR INCREASE IN CREDIT CARD LIMIT Parish City Date Request for Credit Card New Additional If additional: Credit Limit on current card: yes/no yes/no Reason for additional card: Request for Increase in Credit Card Limit Current Limit Temporary Increase Permanent Increase yes/no yes/no Reason for Increase: Signature of Pastor Chancery Approval Date of Chancery Approval Date Request Remitted to BB&T

27 Roman Catholic Diocese of Charlotte REQUEST FOR TRANSFER OF FUNDS Appendix R Parish City Date Account to Transfer From: Account # Account to Transfer To: Account # Date to Transfer Funds: Date of Request: Signature of Pastor Please allow sufficient time for processing transfers to checking accounts. Requests received in our office by Tuesday can be processed by Friday unless it is a holiday week with limited check runs (Easter, Thanksgiving, Christmas) Received at the Diocesan Finance Office Date of Transfer By Whom

28 (Parish/School) Scrip Inventory Listing Appendix S Face Value Date Card Face Date Card Seller Distributed Inventory Entered Vendor Number Value Sold by OnHand General Ledger Account 115 should equal

29 (Parish/School) Scrip Inventory Count Sheet Appendix T Face Number Total Vendor Value of Cards Value Signature Print Name Date Counted By: Verified by:

30 Log of Scrip Seller Activity Appendix U A B C D E F G H Face Beg Card Total Quantity of Value Quantity Value of Value Quantity Number Beginning Cards Cards of Cards Cards of Card of Cards Range Face Value Sold Sold Remaining Remaining Vendor (a * b) (a * e) (b e) (a * g) Totals Signature Printed Name Date Seller #1 Seller #2 Total Cash & Checks Remitted must equal column F I acknowledge receipt of the script cards as shown in Column H and the cash/checks as listed. Total Card Value Returned Signature Printed Name Date must equal column H By: Total

31 Appendix V (Parish/School) Customer Sales Order Date Sold: Sold To: Name of Vendor Face Value of Card Number of Cards Total Total Purchase Payment Enclosed Check/Cash Name of Seller: Scrip Received Signature Printed Name Date CustomerDetach and maintain for your records: Name of Vendor Face Value of Card Number of Cards Total Date From whom Purchased Amount Paid Cash OR Check # ASSUMPTION OF RISK: There may be risks, including, but not limited to, insolvency of the Scrip Provider, insolvancy of participating retailers and breach of personal information (individually and collectively the "Risks"). The Parish/School, the Catholic Diocese of Charlotte, and all of either of their respective affiliates, including, but not limited to any of their respective officers, directors, agents, employees, volunteers, and individuals acting on any of the aforementioned parties' behalf (collectively the "Parish, Catholic Diocese of Charlotte and Its Affiliates") cannot and do not assume responsibility for such Risks. PARTICIPATION CONSTITUTES ACCEPTANCE AND ASSUMPTION OF ALL SUCH RISKS.

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34 Roman Catholic Diocese of Charlotte REQUEST FOR ASSISTANCE WITH NONTUITION COSTS Appendix W School Date: Student: Parent/Contact Info: Activity & Fee: Amount Requested: $ Reason for Need: For Requests of more than $5: Did the family apply for tuition assistance? What percentage of total tuition was awarded? Recommended award: $ If the recommended award is a higher percentage of the activity fee than the percentage of tuition awarded, document the adverse change in the family's circumstances: Signature of Committee Member & Date Signature of Committee Member & Date Signature of Committee Member & Date Signature of Principal & Date

35 Appendix X Catholic Diocese of Charlotte CashBag Inventory Sheet Date Bags Issued Bags Returned Count Team Tag Number Issued to whom Used Unused Initials Total number of bags used:

36 Appendix Y Fund Raiser COUNT SHEET Tickets sold (details on reverse side): Total no. of tickets sold: Price per ticket: Total Ticket Revenue: If Receipts issued, sum of dollar amount from receipts Denomination Quantity Total Amount Verified Count Initials Penny $.1 Nickel $.5 Dime $.1 Quarter $.25 Half Dollar $.5 Dollar $1. Five Dollar $5. Ten Dollar $1. Twenty Dollar $2. Fifty Dollar $5. One Hundred $1. Checks (attach adding machine tape with Item Count) TOTAL Must agree w/sales Revenue Above Counter Signature Date Counter Signature Date

37 Appendix Y LOG OF TICKET/RECEIPT NUMBERS SOLD/USED Ticket #'s Issued / Ticket #'s Returned Ticket #'s Sold / Ticket Quantity Sold (Receipt #'s Issued) (Receipt #'s Unused) (Receipt #'s Used) (Receipt Quantity Used)

38 Appendix Z Remittance Sheet for Funds Collected in Classroom Classroom: Date: Name of Student Cash/Check/Other Purpose Amount Counted By: Funds for deposit agree to funds recorded on remittance sheet Verified by: Total