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* 1. Chapter

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* 2. Name of Officer Filling Out Form

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* 3. What Months is the Chapter Reporting?

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* 4. Beginning Bank Balances (If filling out for multiple months enter in the beginning balance of the first month)

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* 5. Income (If reporting quarterly please enter the cumulative revenue for all three months)

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* 6. Expenses (If reporting quarterly please enter the cumulative expenses for all three months)

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* 7. Ending Balance (If reporting quarterly please enter the ending balance of the last month)

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* 8. Upload Bank Statements

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