Please attach a financial statement(s) for the most previous year below. A current bank statement is adequate.

The information contained in this statement is for the purpose of obtaining funding from the Operation Round Up® Program on behalf of the undersigned. Each undersigned understands that the information provided herein is used in deciding to grant funding, and each undersigned represents and warrants that the information provided is true and complete and that the Operation Round Up® Program consider this statement as continuing to be true and correct until a written notice of a change is provided. The Operation Round Up® Program is authorized to make all inquiries they deem necessary to verify the accuracy of the statements made herein.