Annex "A"
Page 1 of 2
SCHEDULE OF CONTRIBUTIONS/DONATIONS
Name of Foundation/Organization: SEC Registration No.
For the year ended
Part 1 Contributors/ Donors¹
(a) (b) (c) (d) (e)
No. Name and Address1 Nationality2 Total Contributions Type of Contribution3
1 Cash
Non/Cash
P
(Complete Part II if there is
a noncash contribution)
2 Cash
Non/Cash
P
(Complete Part II if there is
a noncash contribution)
3 Cash
Non/Cash
P
(Complete Part II if there is
a noncash contribution)
4 Cash
Non/Cash
P
(Complete Part II if there is
a noncash contribution)
5 Cash
Non/Cash
P
(Complete Part II if there is
a noncash contribution)
6 Cash
Non/Cash
P
(Complete Part II if there is
a noncash contribution)
7 Cash
Non/Cash
P
(Complete Part II if there is
a noncash contribution)
8 Cash
Non/Cash
P
(Complete Part II if there is
a noncash contribution)
9 Cash
Non/Cash
P
(Complete Part II if there is
a noncash contribution)
10 Cash
Non/Cash
P
(Complete Part II if there is
a noncash contribution)
11 Other (aggregate of all contributions Cash
which are individually below P100,000.00) Non/Cash
- by nationality (Complete Part II if there is
a noncash contribution)
(Note: Please use additional forms/sheets or extend the fields for disclosure if necessary)
TOTAL CONTRIBUTIONS/DONATIONS -
A contributor or donor includes individuals, partnerships, corporations, associations, trusts and organizations.
1
If supranational organization, indicate place of principal office or domicile.
2
Annex "A"
Contributions or donations reportable on the Schedule are contributions, donations, grants, bequests, devises, and gifts of
3
money or property, amounting to P100,000.00 or more from each contributor or donor.
Page 2 of 2
Name of Foundation/Organization: SEC Registration No.
For the year ended:
Part 2 Noncash Property
(a) (b) (c) (d)
No. Description of Noncash Property Given Fair Market Value (or estimate) Date received
1
P
2
P
3
P
4
P
5
P
6
P
7
P
8
P
9
P
10
P
Signed under oath by the following:
Signature Signature
Printed Name of President Printed Name of Treasurer
Signed this day of