2016 Chapter Year-End Report

Size: px

Start display at page:

Download "2016 Chapter Year-End Report"

Dwain Stevens
5 years ago
Views:

2016 Chapter Year-End Report PO Box 3696 Oak Brook, IL 60522-3696 877.969.

1 2016 Chapter Year-End Report PO Box 3696 Oak Brook, IL Attention Chapter Leader(s): Reporting requirements of the Internal Revenue Service (IRS) obligate TCF as a 501(c) (3) non-profit organization to obtain a Year-End Report (YER) from each TCF Chapter. Failure to return this completed form will jeopardize your Chapter charter. The Year-End Report consists of two parts the Chapter information and the Chapter financial report. The Chapter information should be filled out by the Chapter leader(s). The financial report should be filled out by the treasurer and returned to the Chapter leader(s) for review and signature before returning to the National Office by the due date. Once you have the complete report, make a copy for your Chapter records. Please send the completed Year-End Report and Annual Membership Fee to the National Office by the due date. Part I Due March 1, 2017 Submit completed YER (Parts I and II) to: The Compassionate Friends, Inc. National Office PO Box 3696 Oak Brook, IL yearendreport@compassionatefriends.org Chapter Number: Chapter Name: Chapter Leader(s): Chapter Contact Information Chapter Mailing Contact phone number(s) for National Roster: Chapter Phone Line Name Can we list the above phone number(s) on the TCF National Website? Yes No Chapter Can we list this address on the TCF National Website? Yes No Chapter Website: Can we include a link on the TCF National Website? Yes No Does your Chapter have a Facebook Page? Yes No If yes, the page is a Public Group/Page Closed Facebook group Link: Can we include a link on the TCF National Website? Yes No Secret Facebook group The 2016 TCF Chapter Financial Report is a required part of this report. The 2016 YER must be returned to the National Office by: March 1, For office use: TR FIN RE SC H G TU

2 Chapter Leader(s) Chapter Leader: Chapter Co-Leader: Preferred Contact #: Preferred Contact #: Chapter Co-Leader: Chapter Co-Leader: Preferred Contact #: Preferred Contact #: Newsletter Does your chapter produce a newsletter? Yes No If no, please explain: Newsletter frequency: Monthly Bi-monthly Quarterly Other Approximate number of newsletters mailed: / ed: each time Is the National Office on your mailing list? Yes No If no, please add the National Office to your mailing list and attach the most recent issue. Monthly Meeting Information Meeting day and time: Location: If yes and a newsletter editor is not listed, please list name and address of newsletter editor below. Editor s Name: Alternate Meeting Location Information Does your Chapter offer more than one meeting location each month? Yes No Meeting day and time: Location Average Meeting Attendance: Largest Meeting Attendance: Average Meeting Attendance: Largest Meeting Attendance: Who are the facilitators? Are the Chapter finances handled separately? Yes No

3 Chapter 2016 Chapter Year-End Report Page 3 Steering Committee/Leadership Does the chapter steering committee meet? Yes No If yes, how often? If no, why not? Other than yourself, list ALL members of the steering committee starting with the treasurer and next the webmaster. Treasurer's Name: Home ( ) ( ) Cell: ( ) Webmaster's Name: Home ( ) ( ) Cell: ( ) List on Leadership Website: Yes No Home ( ) ( ) Cell: ( ) Home ( ) ( ) Cell: ( ) Home ( ) ( ) Cell: ( ) Home ( ) ( ) Cell: ( ) If necessary, please attach additional steering committee member information.

4 Chapter 2016 Chapter Year-End Report Page 4 Subgroups / Special Services of Your Chapter Does your chapter offer a separate sibling meeting? Yes No please indicate age group: If yes, what is the meeting day, time and location Does your chapter offer Spanish speaking support? Yes No If yes, is there a phone contact we can list on the TCF National Website: Would the phone contact like to be added to the National Office Spanish resource list? Yes No Does your Chapter offer any other separate meetings? Miscarriage, Stillbirth, Infant Loss Survivors of Suicide Now Childless Grandparents Other Chapter Programs Does your Chapter hold a Worldwide Candle Lighting service on the second Sunday in December? Yes No If so, what was your attendance for the December 2016 program? If desired, please share any details: Does your Chapter offer any other special programs? Would your Chapter leadership be interested in attending a Regional Chapter Leadership Training Program (RCLTP)? Yes No Would your Chapter be interested in hosting a Regional Chapter Leadership Training Program (RCLTP)? Yes No Regional Coordinators TCF s Regional Coordinators are available to provide additional support for you and the Chapter leadership. Has your Regional Coordinator been in contact with your Chapter? Yes No Select all that apply: by by phone attended a Chapter meeting or Chapter event held a Regional Chapter Leadership Training Program other: Is there anything else you would like to share? Chapter Feedback Is there anything else you would like us to know?

5 2016 Chapter Year-End Financial Report Part II 1. How many donors contributed $250 or more in a single donation in 2016? (include a copy of the acknowledgement letter if not already sent to the National Office) 2. $ Beginning total balance of ALL chapter held accounts and funds as of 1/01/16 (See adjusted bank balance on the 2015 Year-End Report) 3. $ Savings balance as of 12/31/16 4. $ Checking balance as of 12/31/16 5. $ Certificates of Deposit/Money Market Funds as of 12/31/16 6. $ Other (Explanation Required) 7. $ Total of all chapter accounts as of 12/31/16* (add lines 3-6) 2016 Income Received 8. $ Donations (love gifts, memorials, individual/corporate donations, etc.) 9. $ Online Donations (Online Source: ) 10.$ Fundraising Project: (Income $ - Fundraising expenses $ ) Do not deduct again in expense section $ Fundraising Project: (Income $ - Fundraising expenses $ ) Do not deduct again in expense section 11.$ Regional Conference Net Income 12.$ Interest 13.$ United Way 14.$ Other (Explanation Required) 15.$ Add lines 8 through 14 (this is your total 2016 unrestricted income) Restricted Gifts Definition: Restricted gifts are donations that are made for a specific purpose Value $ Attach documentation chosen by the donor. This purpose must be stated in writing at the time of the donation by the $ Total Value of ALL In-Kind Donations received in 2016 donor, please attach documentation. Restricted gifts may only be used for their intended purpose. Restricted Fund (1) 16. Purpose: Start date of fund: Balance from previous year: $ 16a. Amount received in 2016 $ 16b. Amount deducted in 2016: $ 16c. Balance in fund as of 12/31/16: $ Restricted Fund (2) 17. Purpose: Start date of fund: Balance from previous year: $ 17a. Amount received in 2016: $ 17b. Amount deducted in 2016: $ 17c. Balance in fund as of 12/31/16: $ Please list additional restricted funds on a separate sheet and attach 18. $ Add line 16a and line 17a (this is your total 2016 restricted income) 19. $ Total of lines 15 and 18 (this is your 2016 income) If total income is $50,000 or more contact the National Office as soon as possible for further IRS reporting requirements. 20. $ Multiply line 15 times 10% This is the Annual Membership Fee amount due. Attach copies of ALL 2016 monthly bank statements for the ENTIRE YEAR showing balances for ALL Chapter held accounts and funds. 21. $ Enter the Annual Membership Fee being paid If line 20 is less than $100.00, the suggested minimum Annual Membership Fee is $100. Important Instructions: This report must be completed by the Chapter Treasurer and returned to the Chapter Leader for review. It is the responsibility of the Chapter Leader to sign this report and mail it along with Part I, the Annual Membership Fee, and required material to the National Office to comply with the Year-End Reporting requirements. In-Kind Donations (single donation) received valued at $ & up: (In kind donations are a service or good this is NOT cash or checks) Donor: Value $ Attach documentation Donor:

6 2016 Chapter Expenses **If you deducted a fundraising expense on line 10 (Income Section) do not list as an expense below 22. $ Annual Membership Fee Paid During $ Chapter Patron Donation 24. $ Meeting Place Expenses 25. $ Bank Service Charges 26. $ Printing 27. $ Postage 28. $ PO Box Rental 29. $ Books, Brochures, DVD s, CD s, etc. 30. $ Telephone/Answering Service 31. $ Program Expenses 32. $ Conference Attendance Support 33. $ Meeting Supplies 34. $ Chapter Leadership Training Programs 35. $ Website 36. $ Chapter Outreach 37. $ Worldwide Candle Lighting 38. $ Other (Explanation Required) 39. $ Other (Explanation Required) 40. $ Total 2016 Expenses (add lines 22-39) Notes Office Notes: Adjustments to Bank Balance 41. $ Amount of funds collected in 2016 but not deposited until 2017 This income must be included under Chapter Income. Any checks written in 2016 that did not clear by 12/31/16? If so, list the check numbers and amount: If you $ report does Amount, not ba Check lance, # please include you lan $ Amount, Check # $ Amount, Check # $ Amount, Check # 42. $ Total The expenses corresponding with these checks must be included under Chapter Expenses. Treasurer: Chapter Leader: Does your report balance? $ Line 2 $ Line 7 $ + Line 19 $ + Line 41 $ - Line 40 $ - Line 42 $ Report Total should equal $ Adjusted Bank Balance Signature Print Date Signature Print Date

7 Anti-Terrorism Compliance On behalf of # I hereby certify that: All monies donated to this chapter of The Compassionate Friends (TCF) are used to advance the purposes of TCF; The chapter does not make distributions to foreign charities or any other foreign organizations, and if it desires to make such a distribution, a Regional Coordinator will contact the TCF home office for authorization and directions to ensure that such distributions are in keeping with all laws, statutes, and regulations restricting U.S. persons from dealing with any individuals, entities, or groups subject to OFAC sanctions. Print Chapter Leader s Name: Chapter Leader s Signature: Print Treasurer s Name: Treasurer s Signature:

Partners In Development, Inc. Serving the poorest of the poor since 1990

Partners In Development, Inc. Serving the poorest of the poor since 1990 Third-Party Fundraising Guidelines Thank you for your interest in fundraising to benefit (PID) We appreciate your willingness to make a contribution. We ask that you adhere to the following guidelines