Transmittal Form

Printable .pdf

TRANSMITTAL REPORT

               Parish Name_____________________ Date Mailed _____________________

               Town____________________________Prepared By_____________________

               Parish CFSA Goal__________________Phone Number___________________

               1. Number of pledge cards enclosed ________________________________

               2. Total amount pledged on enclosed cards _____________________________

* * * * * * * * * * * * * * * *

               3. CFSA Parish Goal _______________________________________________

               4. Payment Enclosed _______________________________________________

               5. Total Previous Payments sent to CFSA Office ___________________________

               6. Misc. Adjustments

                                     Description                                 Amount

               a. _______________________ _______________________

               b. _______________________ _______________________

               c. _______________________ _______________________

               d. _______________________ _______________________

               7. Total amount remaining to reach parish CFSA goal ______________________

Back to top