DA Form 4926 Chaplains' Fund Annual Summary Financial Data Report

DA Form 4926 - also known as the "Chaplains' Fund Annual Summary Financial Data Report" - is a Military form issued and used by the United States Department of the Army.

The form - often mistakenly referred to as the DD form 4926 - was last revised on September 1, 1999. Download an up-to-date fillable PDF version of the DA 4926 below or request a copy through the chain of command.

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CHAPLAINS' FUND ANNUAL SUMMARY FINANCIAL DATA REPORT
For use of this form, see DA PAM 165-18; the proponent agency is CCH
1. NAME OF FUND
2. FISCAL YEAR
3. NAFI CODE
4. ADDRESS OF FUND
5. SUB-ACCOUNT
SECTION A - INCOME/EXPENSE STATEMENT
OPERATING INCOME
OPERATING EXPENSES
Regular Chapel Offerings
1.5% Transfer
Receive Designated Offerings
Mandatory Drawdown (30%)
Donations
Travel and Transportation of Persons
Grants
Travel and Transportation of Things
Interest Income
Rentals (Equipment and Facilities)
Proceeds from Sale of Fund-Owned Property
Communications
Inter-Fund Transfers (Fund-to-Fund In-Bound)
Contractual Services
RIMP Reimbursement
Supplies
Equipment (unit cost over $100.00 each)
Pay Designated Offerings (External)
Insurance
Bank Charges
Replenish Petty Cash
Inter-Fund Transfer (Fund-to-Fund Out-Bound)
RIMP Loss
TOTAL OPERATING INCOME
TOTAL OPERATING EXPENSES
NET INCOME OR LOSS FOR FISCAL YEAR (Income less Expenses)
Adjustments in Favor of the Fund
Adjustments Against the Fund
Net Adjustments in Favor or Against the Fund
Memorandum: Designated Offerings Transferred Internally
SECTION B - STATEMENT OF NET WORTH
(Year)
Net Worth Beginning 1 October
(Year)
Net Income or Loss for Period 1 October thru 30 September
Net Adjustments in Favor or Against the Fund
Add Petty Cash
Total Net Worth Per Balance Sheet
Memorandum: Purchase Cost of Fixed Assets
SECTION C - 30% DRAWDOWN
Total Operating Income
Total Net Worth
-
-
Less Income from Exempt Sources
Less Actual Balance from Exempt Sources
Adjusted Income
Adjusted Net Worth
Multiplied by 30%
Less 3-Month Operating Balance
3-Month Operating Balance
Less Outstanding Purchase Orders
Result
Amount of Drawdown (if necessary)
DA FORM 4926-R, MAY 89, IS OBSOLETE
DA FORM 4926, SEP 1999
APD LC v1.00
CHAPLAINS' FUND ANNUAL SUMMARY FINANCIAL DATA REPORT
For use of this form, see DA PAM 165-18; the proponent agency is CCH
1. NAME OF FUND
2. FISCAL YEAR
3. NAFI CODE
4. ADDRESS OF FUND
5. SUB-ACCOUNT
SECTION A - INCOME/EXPENSE STATEMENT
OPERATING INCOME
OPERATING EXPENSES
Regular Chapel Offerings
1.5% Transfer
Receive Designated Offerings
Mandatory Drawdown (30%)
Donations
Travel and Transportation of Persons
Grants
Travel and Transportation of Things
Interest Income
Rentals (Equipment and Facilities)
Proceeds from Sale of Fund-Owned Property
Communications
Inter-Fund Transfers (Fund-to-Fund In-Bound)
Contractual Services
RIMP Reimbursement
Supplies
Equipment (unit cost over $100.00 each)
Pay Designated Offerings (External)
Insurance
Bank Charges
Replenish Petty Cash
Inter-Fund Transfer (Fund-to-Fund Out-Bound)
RIMP Loss
TOTAL OPERATING INCOME
TOTAL OPERATING EXPENSES
NET INCOME OR LOSS FOR FISCAL YEAR (Income less Expenses)
Adjustments in Favor of the Fund
Adjustments Against the Fund
Net Adjustments in Favor or Against the Fund
Memorandum: Designated Offerings Transferred Internally
SECTION B - STATEMENT OF NET WORTH
(Year)
Net Worth Beginning 1 October
(Year)
Net Income or Loss for Period 1 October thru 30 September
Net Adjustments in Favor or Against the Fund
Add Petty Cash
Total Net Worth Per Balance Sheet
Memorandum: Purchase Cost of Fixed Assets
SECTION C - 30% DRAWDOWN
Total Operating Income
Total Net Worth
-
-
Less Income from Exempt Sources
Less Actual Balance from Exempt Sources
Adjusted Income
Adjusted Net Worth
Multiplied by 30%
Less 3-Month Operating Balance
3-Month Operating Balance
Less Outstanding Purchase Orders
Result
Amount of Drawdown (if necessary)
DA FORM 4926-R, MAY 89, IS OBSOLETE
DA FORM 4926, SEP 1999
APD LC v1.00

Download DA Form 4926 Chaplains' Fund Annual Summary Financial Data Report

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