Camp/Lodge Financial Report '09

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* Camp/Lodge No.:
* Camp/Lodge City & State:
* Name of Camp/Lodge Banker/Treasurer:
Assets - Please record balance/value at 12/31/09 for assets listed below:
Cash-Checking Account:
Cash-Savings Account:
Cash-Savings and Loan Account:
Bonds:
Common or Preferred Stock:
Real Estate:
US Savings Bonds:
Other Assets:
* Total Assets:
Liabilities - Please record liability amounts at 12/31/09 for the liabilities listed below:
Notes Payable:
Installment Accounts Payable:
Mortgage Payable on Real Estate:
Chattel/Secured Mortgages:
Unpaid Taxes:
Other Liabilities:
* Total Liabilities:
* Name, Address, City, State and Zip of Bank where bank accounts are held:
Name, Address, City, State and Zip of Savings & Loan if applicable:
* Does your Camp/Lodge Managers/Trustees or other Camp/Lodge officer(s) complete an audit or review of the Camp/Lodge financial books/account as reported by the Banker/Treasurer each year?	Yes No
If not, please arrange such an audit or review with the apppropriate camp/lodge officers.:

Woodmen of the World
Assured Life Association
8000 E. Maplewood Ave. Suite 105
Greenwood Village, CO 80111-4727
1-800-777-9777
fraternal@denverwoodmen.com