SAMPLE CHARITY. PERFORMANCE REPORT Tier 3. for the year ended 31 March 2015

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SAMPLE CHARITY PERFORMANCE REPORT Tier 3 for the year ended 31 March 215

Contents Non-Financial Information: Page Entity Information s 3 Statement of Service Performance 4 Financial Information: Statement of Financial Performance 6 Statement of Financial Position 7 Statement of Cash Flows 8 Statement of Accounting Policies 9 Notes to the Performance Report 1 Auditor s Report These reports present a true and accurate view of the organisation s finances

Entity Information Sample Charity Legal Name of Entity Sample Charity Other Name of Entity (if any) Type of Entity and Legal Basis (if any) Charity Registration Number 123456789 Entity's Purpose or Mission We exist to reduce poverty by: educating children helping those in need building better communities Entity Structure Incorporated Association Main Sources of the Entity's Cash and Resources Fundraising from the general public Door to door collections from the public Main Methods Used by the Entity to Raise Funds 9% of collection is done by volunteers Entity's Reliance on Volunteers and Donated Goods or Services 1234 Main Street AUCKLAND The charity is the oldest in the country Additional Information There is no relevant additional information Contact Details Physical Address 123 Main Street AUCKLAND Postal Address Email/Website PO Box 1234 AUCKLAND info@samplecharity.co.nz www.samplecharity.co.nz Phone 9 1234 5678 Facebook Twitter www.facebook.com/samplecharity @samplecharity

Education Services Provided Hours of client contact Nights of Accommodation Provided Statement of Service Performance Sample Apr 215 - Mar 216 This Year Actual 3,996 4,5 2,592 Apr 215 - Mar 216 This Year Budget 3,996 3,996 2,196 Apr 214 - Mar 215 Last Year Actual 4,59 4,14 3,83 Printed from Calxa 6/3/216 14:5 Page 4 of 22

Description of Outcomes Additional Output Measures Additional Information

Statement of Financial Performance Sample Income Donations, fundraising and other similar revenue Fees, subscriptions and other revenue from members Revenue from providing goods or services Total Income Expense Expenses related to public fundraising Volunteer and employee related costs Costs related to providing goods or services Grants and donations made Other Expenses Total Expense Operating Surplus/Deficit Apr 215 - Mar 216 This Year Actual 169,362 1,28,43 42,292 1,239,698 8,522 1,142,132 7,49 228 65,498 1,223,428 16,269 Apr 215 - Mar 216 This Year Budget 16,65 966,993 4,16 1,167,74 8,82 1,79,271 6, 238 62,148 1,155,74 11,964 Apr 214 - Mar 215 Last Year Actual 149,45 9,46 37,32 1,87,23 7,52 1,1,262 6,22 218 58,246 1,73,467 13,763 Printed from Calxa 6/3/216 14:5 Page 6 of 22

Mar 216 Account tree: «Original Account Tree» Account types: Asset, Liability, Equity Asset Current Assets Cash at Bank - Unrestricted Cash at Bank - Restricted Other Financial Assets Accounts Receivable Buildings Motor Vehicles Less: Accum Depreciation Total Asset Liability Trade Creditors Current Liabilities Accrued Expenses GST Payable Less GST Receivable PAYG Withholding Payable Superannuation Payable Grants Received in Advance Total Liability Net Assets Equity Retained Surplus (Losses) Current Year Surplus (Deficit) Total Equity Statement of Financial Position Sample This Year 37,543 6,543 31, 7, 7, 11, 12, (53,) 212,543 (38,75) 178,633 8, 37,8 (374) 5, 9, 12, 14,558 71,984 6,72 16,269 76,99 Last Year 44,819 13,819 31, 7, 7, 11, 12, (53,) 219,819 (9,88) 173,984 8, 32,64 (656) 5, 9, 12, 164,14 55,715 46,768 13,763 6,531 Printed from Calxa 6/3/216 14:5 Page 7 of 22

Statement of Cash Flows Sample Apr 215 -Mar 216 Account tree: NZ NFP Reporting Apr 215 -Mar 216 Bank at Beginning 44,819 Apr 214 -Mar 215 52,549 Cashflow from Operating Activities: Net Profit Adjustments for Balance Sheet Movement on Operating Activities: Liability Money Payable By the Entity Trade Creditors Superannuation Payable Net GST Total Adjustments for Balance Sheet Movement on Operating Activities Net Cashflow from Operating Activities Cashflow from Investing Activities: Asset Other Resources Buildings Net Cashflow from Investing Activities Net Cashflows Bank at End 16,269 (23,545) (23,545) (28,195) 4,65 (23,545) (7,276) (7,276) 37,543 13,763 (493) (493) (8,88) 5, 3,387 (493) 13,27 (21,) (21,) (21,) (21,) (7,73) 44,819 Printed from Calxa 6/3/216 14:5 Page 8 of 22

Statement of Accounting Policies Basis of Preparation Sample Charity has elected to apply PBE SFR-A (NFP) Public Benefit Entity Simple Format Reporting - Accrual (Not-For-Profit) on the basis that it does not have public accountability and has total annual expenses of equal to or less than $2,,. All transactions in the Performance Report are reported using the accrual basis of accounting. The Performance Report is prepared under the assumption that the entity will continue to operate in the foreseeable future. Goods and Services Tax (GST)* All amounts are recorded exclusive of GST, except for Debtors and Creditors which are stated inclusive of GST. OR (Delete one not applicable to the entity) Goods and Services Tax (GST)* Sample Charity is not registered for GST. Therefore amounts recorded in the Performance Report are inclusive of GST (if any). Income Tax Sample Charity is wholly exempt from New Zealand income tax having fully complied with all statutory conditions for these exemptions. Bank Accounts and Cash Bank accounts and cash in the Statement of Cash Flows comprise cash balances and bank balances (including short term deposits) with original maturities of 9 days or less. Tier 2 PBE Accounting Standards Applied (if any) Changes in Accounting Policies There have been no changes in accounting policies during the financial year (last year - nil) OR (Delete one not applicable to the entity) Changes in Accounting Policies

Note 1 Analysis of Revenue Sample Income Fundraising Receipts Fundraising - Gifts Fundraising - Contributions Grants and Donations Grants (Cwlth) - Op - Rcnt Grants (Cwlth) Op - Non-R Grants (Cwlth) - Capital Grants (State) Op - Recurrent Grants (State) Op - Non-R Grants (State) - Capital Grants (Local) Op - Recurrent Grants (Local) Op - Non-R Grants (Local) - Capital Grants - Other Receipts from providing goods or services Sales of Goods Interest, dividends and other investment income receipts Interest - Restricted Other receipts Other/Sundry Income Total Income Apr 215 - Mar 216 Actuals 42,485 23,261 19,224 1,154,921 74,873 267,852 55,319 126,877 42,292 42,292 1,239,698 Apr 214 - Mar 215 (YTD)Actuals 37,49 2,526 16,964 1,12,42 622, 236,36 42,1 111,96 37,32 37,32 1,87,23 Printed from Calxa 6/3/216 14:5 Page 1 of 22

Note 2 Analysis of Expenses Sample Expense Expenses related to public fundraising Fundraising Expenses - General Insurance - Public Liability Legal Fees Meeting Expenses Volunteer and employee related costs Wages & Salaries Annual Leave Expense Long Service Leave Expense Sick Leave Expense Superannuation Workers' Compensation Staff Amenities Training & Development (Staff) Travel & Accommodation Utilities Costs related to providing goods or services Purchases Grants and donations made Dpcn - Building Dpcn- Motor Vehicle Dpcn - Plant & Equip Fees & Permits Other Expenses Accounting Fees Advertising & Promotion "Assets Purchases <$5," Audit Fees Bank Charges Computer Expenses Insurance - General Insurance - Prof Indemnity Membership Fees Paid Motor Vehicle Expenses Postage, Freight & Courier Printing & Stationery Rent Repairs & Maintenance Telephone & Fax Charges Total Expense Apr 215 - Mar 216 Actuals 8,522 6,48 2,115 1,142,132 985,858 88,727 2,563 35,269 2,96 26,753 7,49 7,49 228 228 65,498 8,971 1,518 458 19,224 4,16 22,865 564 3,845 1,833 2,115 1,223,428 Apr 214 - Mar 215 (YTD)Actuals 7,52 5,654 1,866 1,1,262 863,96 77,752 2,262 31,123 2,612 23,68 6,22 6,22 218 218 58,246 7,916 1,431 44 16,964 3,895 2,262 498 3,393 1,617 1,866 1,73,467 Printed from Calxa 6/3/216 14:5 Page 11 of 22

Note 3 Analysis of Assets and Liabilities Sample Mar 216 This Year Asset Bank Accounts and Cash 37,543 Cash at Bank - Unrestricted 6,543 Cash at Bank - Restricted 31, Debtors and Prepayments 7, Accounts Receivable 7, Other Non-Current Assets 168, Buildings 11, Motor Vehicles 12, Less: Accum Depreciation (53,) Total Asset 212,543 Liability Creditors and Accrued Expenses 11,558 Trade Creditors (38,75) Accrued Expenses 8, GST Payable 37,8 Less GST Receivable (374) PAYG Withholding Payable 5, Employee Costs Payable 9, Superannuation Payable 9, Unused Donations and Grants with Conditions 12, Grants Received in Advance 12, Total Liability 14,558 Net Assets 71,984 Last Year 44,819 13,819 31, 7, 7, 168, 11, 12, (53,) 219,819 35,14 (9,88) 8, 32,64 (656) 5, 9, 9, 12, 12, 164,14 55,715 Printed from Calxa 6/3/216 14:5 Page 12 of 22

Note 4: Property, Plant and Equipment This Year Asset Class* Opening Carrying Purchase Sales - Disposals Current Year Closing Deprecia-tion Carrying Amount* and Impairment Amount* Land* - - - Buildings* - - Motor Vehicles* - - Furniture and fixtures* - - Office equipment* - - Computers (including - - software)* Machinery* Heritage assets Total - - - - - - - - - Current Valu-ation Source and Date of Valuation

Note 4: Property, Plant and Equipment Last Year Asset Class* Opening Carrying Amount* Purchase Sales - Disposals Current Year Depreciation and Impairment Land* - - - Buildings* - - Motor Vehicles* - - Furniture and fixtures* - - Office equipment* - - Computers (including - - software)* Machinery* - - Heritage assets - - Total - - - - - Closing Carrying Amount* Significant Donated Assets Recorded - Source and Date of Valuation None Significant Donated Assets - Not Recorded None

Mar 216 Equity Retained Surplus (Losses) Current Year Surplus (Deficit) Asset Revaluation Reserve Other Reserves Historical Balancing Account Total Equity Note 5 Accumulated Funds Sample This Year 6,72 16,269 76,99 Last Year 46,768 13,763 6,531 Printed from Calxa 6/3/216 14:5 Page 15 of 22

Note 5 Accumulated Funds: Breakdown of Reserves Actual Actual This Year Last Year Name Nature and Purpose $ $ Total - -

Note 6: Commitments and Contingencies Commitments Commitments to Lease or Rent Assets Commitment to Purchase Property, Plant or Equipment Commitment to Provide Loans or Grants At Balance Date This Year At Balance Date Last Year Contingencies Contingent Liability Guarantees Provided At Balance Date This Year At Balance Date Last Year

Note 7: Other Significant Grants and Donations with Conditions which have not been Recorded as a Liability Description Original Amt Not Fulfilled Amt Purpose and Nature of the Condition(s) Goods or Services Provided to the Entity in Kind Description Amount Assets Used as Security for Liabilities Nature and Amount of Borrowing Nature and Amount of Asset Used as Security

Note 8: Assets Held on Behalf of Others Description of the Assets Held* Name of Entity of Whose Behalf Assets are Held*

Note 9: Related Party Transactions This Year Last Year This Year Last Year $ $ $ $ Description of Related Party Relationship* Description of the Transaction (whether in cash or amount in kind)* Value of Transactions* Value of Transactions* Amount Outstanding* Amount Outstanding* OR (Delete one not applicable to the entity) There were no transactions involving related parties during the financial year. (Last Year - Nil)

Note 1: Events After the Balance Date This Year Nature of Event* Estimate of Financial Effect* Effect, if any on the entity's ability to continue operating* OR (Delete one not applicable to the entity) There were no events that have occurred after the balance date that would have a material impact on the Performance Report. (Last Year Nil)

Note 11: Ability to Continue Operating Note 12: Correction of Errors Additional Information