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<br />Attachments <br />4. ATTACHMENTS <br /> <br />Description of Required Attachments <br /> <br />a) Financial Audit <br />A recent financial audit that should cover CY2021, for calendar year agencies, and FY2021- <br />2022, for fiscal year agencies. For agencies with prior year revenues totaling $500,000 or <br />more a financial audit, prepared by a certified public accountant is required. Agencies with <br />prior year revenues of less than $500,000 may submit a completed Schedule of Receipts and <br />Expenditures form (see application materials), in lieu of an audit/report. Agencies with a <br />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 /> <br />b) Agency Budget <br />Please complete the provided template or submit your own budget file (as long as it contains <br />the same information, and in a similar format, as requested in the provided template. Please <br />explain other in your budget). Agency Budget Template is listed on the Town’s and County <br />website here. Please submit In PDF form only. <br /> <br />c) Program Budget <br />You may complete the provided template, or you may submit your own budget file (as long as <br />it contains the same information, in the same format, as requested in the provided template. <br />Please explain other in your budget). Program Budget Template is listed on the Town’s and <br />County website here. Please submit in pdf 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 <br />agency’s financial activity. Review the IRS’ table guide, for more details. For Form 990-N (e- <br />postcard) filers, include a copy of the postcard, with the agency’s application materials. <br /> <br />e) NC Solicitation License <br />A copy of the agency’s current solicitation license is required. Organizations that solicit <br />contributions in North Carolina, directly or through a third party, must renew their licenses <br />annually. For more details, refer to the NC Secretary of State’s licensing website and its <br />Frequently Asked Questions Guide (PDF), about exemptions. If exempt per N.C.G.S. § 131F- <br />3, include a copy of the exemption letter with the agency’s application materials. <br /> <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 <br />required. An agency can request a copy of its letter from the IRS’ Customer Account Services. <br /> <br />g) List of Board of Directors <br />Provide the following information about each board of director’s member: name, telephone <br />number, address, occupation or affiliation of each member and the list must identify the <br />principal officers of the governing body, and length of term. <br /> <br /> <br /> <br />DocuSign Envelope ID: A24D2229-012E-4233-A6F8-624A53BCF7DA