<p> Delta Council of PTAs – Unit Remittance Form Units must use this sheet when submitting funds, financial or tax reports, or audits to council.</p><p>Date ______Unit Name ______State PTA ID Number ______Unit Address ______City/Zip ______Total membership on this report: ______</p><p>Membership dues #______@ $ ______Monthly Pass through Council $1.00, District $0.40, State $2.00, National $2.25 ______</p><p>Nov 15 Insurance premium – Required – rate announced late October. ______</p><p>Dec 1 Late fee for insurance payment if submitted after council due date ($25.00) ______</p><p>Jan 4 Workers Compensation Form-REQUIRED. Write NO PAYMENTS MADE or see below ______</p><p>Jan 4 Workers Compensation surcharge (5% on amount exceeding $1000) paid to individuals ______</p><p>Founders Day Free Will Offering ______</p><p>Council Assessment ______</p><p>Membership Envelopes ______</p><p>Other ______Make checks payable to: DELTA COUNCIL of PTAs All checks must have TWO SIGNATURES. TOTAL ______Make a copy of this form and reports for your records. Treasurer 2015-2016 ___ Annual Financial Report, ___ IRS 990, ___ FTB 199, ___ RFF1 2 copies 2016-2017 ____ Budget Auditor ___ 1/1/16-6/30/16 Fiscal Year End AUDIT. ___7/1/16-12/31/16 Mid Year AUDIT. 2 copies</p><p>From Unit Treasurer / Auditor ______Phone ______Address ______City/Zip ______E-mail ______</p><p>Mail Financial Payments, Reports Audit Reports & Tax filings To Council Treasurer Council Auditor Stephen Mohammed Misty Jackson Address 2217 Hamlin Drive 153 Coral Bell Way City/Zip Antioch, CA 94509 Oakley, CA 94561 Phone 925-478-1464 925-625-7714 Email [email protected] [email protected]</p>