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OHIO STATE UNIVERSITY EXTENSION
Ohio 4-H Club/Affiliate Yearly Financial Summary
Due January 31
Program Year Club/Affiliate Name
Bank Name
EIN
Account Number
Bank Address
Bank City/ST/Zip
Type of Account (select one):
Checking
Savings
Other (please list) -
Who is authorized to sign your checks? (must have at least one name, preferably two names)
Beginning Account Balance as of Jan. 1 (should match bank statement)
Club/Affiliate Income (please list, add separate page if needed)
Description (fundraiser, dues, etc.)
Amount
Description (fundraiser, dues, etc.)
Amount
Total Income
Club/Affiliate Expenses (please list, add separate page if needed)
Description (books, program fees, etc.)
Amount
Description (books, program fees, etc.)
Amount
Total Expenses
Ending Account Balance as of Dec. 31 (should match bank statement):
Name of person completing form: