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SRG Reporting

Acts Ministry, Inc. Service, Reporting & Gifting Guidelines
(SRG)
Effective January 1, 2016

Name of Individual/Ministry:_________________________________________________________Credential Titles:
1. Ordained Ministers & Pastors__        4. Licensed Missionaries__
2. Licensed Ministers & Pastors __        5. Licensed Christian workers__
3. Licensed Ministries__                           6. Licensed Outreaches, Fellowships, Missions, & Outreaches__
                SRG Reporting: Dated: From___/___/___/—to—___/___/___/
Address:__________________________________________________________________________________________________________________________________________________________________________________________________________________________

Type of Works:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Recent time period results:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Assets $________________________________ Liabilities $_________________________________Balance$________________
Revenue$______________________________ Expenses $_________________________________Balance $_______________
Outstanding Contingencies: Lawsuit_______________, Personnel change________ Relocation________________
Major Expenditures (Explain)________________________________________________________________________________
Other____________________________________________________________________________________________________________
Attach copy of your latest 990 IRS Filing and any subsequent amendments or clarifications.
__________________________________________________________________________________________________________________

SRG Service:
Explain your service to Acts Ministry, Inc. for the Reporting above dated
from___/___/___/—to—___/___/___:
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
                SRG Giving:
Confirm financial support to Acts Ministry, Inc.. Its vision “Unity in Christ through The Holy Spirit,”
and mission “Serving where Needed,” by “Doing the Right Thing.”
Amount given for the period: $_____________  and I affirm my commitment to the Acts Ministry vision and mission by my signature.

Signed________________________________________________ Printed______________________________Dated: __/__/__/

Social Security Number__ __ __-__ __-__ __ __ __ OR EIN __ __- __ __ __ __ __ __ __
(Please, “O” or not applicable where space is given for response.)