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4. ATTACHMENTS <br />Description of Required Attachments <br />a)Financial Audit <br />A recent financial audit that should cover CY2021,for calendar year agencies,and FY2021-2022,for fiscal year <br />agencies.For agencies with prior year revenues totaling $500,000 or more a financial audit,prepared by a <br />certified public accountant is required.Agencies with prior year revenues of less than $500,000 may submit a <br />completed Schedule of Receipts and Expenditures form (see application materials),in lieu of an audit/report. <br />Agencies with a certified audit/report should not complete the form.Schedule of Receipts and Expenditures <br />form is listed on the Town’s and county website here. <br />b)Agency Budget <br />Please complete the provided template or submit your own budget file (as long as it contains the same <br />information,and in a similar format,as requested in the provided template.Please explain other in your <br />budget).Agency Budget Template is listed on the Town’s and County website here.Please submit In PDF form <br />only. <br />c)Program Budget <br />You may complete the provided template,or you may submit your own budget file (as long as it contains the <br />same information,in the same format,as requested in the provided template.Please explain other in your <br />budget).Program Budget Template is listed on the Town’s and County website here.Please submit in pdf <br />only. <br />d)IRS Federal Form 990 <br />A copy of the agency’s 2020 Form 990 is required.The specific form depends upon the agency’s financial <br />activity.Review the IRS’table guide,for more details.For Form 990-N (e-postcard)filers,include a copy of the <br />postcard, with the agency’s application materials. <br />e)NC Solicitation License <br />A copy of the agency’s current solicitation license is required.Organizations that solicit contributions in North <br />Carolina,directly or through a third party,must renew their licenses annually.For more details,refer to the <br />NC Secretary of State’s licensing website and its Frequently Asked Questions Guide (PDF),about exemptions. <br />If exempt per N.C.G.S.§131F-3,include a copy of the exemption letter with the agency ’s application <br />materials. <br />f)IRS Federal Tax-Exemption Letter <br />A copy of the agency’s current IRS tax-exempt letter that confirms its nonprofit status is required.An agency <br />can request a copy of its letter from the IRS’ Customer Account Services. <br />g)List of Board of Directors <br />Provide the following information about each board of director ’s member:name,telephone number,address, <br />occupation or affiliation of each member and the list must identify the principal officers of the governing <br />body, and length of term. <br />AttachmentsPage 17 of 24 <br />DocuSign Envelope ID: B7578AEA-ACB5-4FAD-8F8A-86A7F4B5A037