[Name]

Statement of Accounts
for the period 19/09/2014 – 07/05/2015

[Name] Statement of accounts for the

period (19/09/2014 – 07/05/2015)
 1. Administrative information
Registered address
Registered Address of non-party campaigner

Responsible Person
For the purposes of the Political Parties Elections Referendums Act 2000 the
responsible person is:

Name Position

2. Financial activities
Income overview

Expenditure overview

Statement of financial position (balance sheet) overview

3. Income and expenditure account

Income 19/09/2014 – 07/05/2015
(£)
*Total income

Expenditure 19/09/2014 – 07/05/2015

(£)
*Total expenditure

Deficit/surplus for regulated period

 4. Statement of financial position (balance sheet)
As at 07/05/2015
(£)
Assets
Total non-current(fixed) assets

Total current assets

*Total assets

Liabilities
*Total liabilities

Total net assets/(liabilities)

Reserves
Accumulated fund bfwd

Surplus/(deficit)

Accumulated fund cfwd

Revaluation reserve

Other funds

Total reserves

Declaration
In accordance with Section 99A of the Political Parties, Elections and Referendums
Act 2000, I declare that I have examined this statement of accounts and to the best of
my knowledge and belief it is complete and correct as required by law.

Responsible Person’s Signature Date