Chapter Financial Information and Annual Update Form

This information should be updated at the beginning of each fiscal year and is required to maintain Active Status.

Forms must be submitted by May 22, 2024.

Name of Chapter *

Primary Financial Contact *

Contact Phone Number *

Chapter EIN *

BANKING

Make your Bank Contact aware that their information was given to the NAA for follow-up.
Have them make note that information about the account can be provided to the NAA.

Bank Name *

Bank Phone Number *

Bank Address *

Primary Bank Contact *

Bank Contact Phone Number *

Name on the Account *

BALANCES

Chapters are required to update this Information annually as part of the requirements to be considered an Active Chapter.
If necessary, the Chapter should be able to provide bank statements and/or a balance sheet and income statement by May 22.

Balance as of June 30 *

SIGNATURE CARD

Accounts must have at least two people listed on the signature card.
The NAA requires two-party signature checks with non-related parties.
The NAA strongly recommends having a third individual with access to the bank statements.

Name 1 *

Name 2 *

Name 3

Name 4

SIGN AND DATE

By signing below, you agree to hold a semiannual review of chapter bank records with all individuals with signing power and access to bank statements.

Signature

Reset Signature

Draw your signature in the white space above the line.

Date *