ANTELOPE VALLEY QUILT ASSOCIATION

INCOME

1.	AMOUNT: ________________________________________________________

2.	BUDGET CATEGORY: _____________________________________________

3.	SOURCE OF INCOME: _____________________________________________

4.	TOTAL AMOUNT OF CHECKS: _____________________________________ 
(List checks on reverse or attach a list)

5.	 TOTAL CASH:____________________________________________________

6.	TOTAL DEPOSIT: _________________________________________________

7.	YOUR SIGNATURE: _______________________________________________

8.	DATE: ___________________________________________________________

Date received by Treasurer: _______________________

Date deposited by Treasurer: ______________________