UNIT REMITTANCE FORM - downloads.capta.org

1 unit REMITTANCE FORMU nits must use this sheet when submitting monies to _____Unit Name _____State PTA ID Number _____Unit Address _____City/Zip _____Council _____District PTA _____Total membership on this report: _____Treasurer _____Telephone (_____)_____Address _____City/Zip _____Email_____Make check payable to: to council treasurer: Name _____Address_____City/Zip_____All checks must have TWO a copy for your following statement must appear on all local REMITTANCE statements in order that the National PTA publication,Our Childrenmay qualify for second-class entry mailing: A portion of the total sum sent for the National portion of PTA membership dues is payment for one year s subscription to Our Childrenof the National Congress of Parents and Teachers, which will be sent to the presidentof each local unit .

2 DESCRIPTIONAMOUNTM embership dues: # _____ @ $ _____(Council, district, State, National PTA portions)$Insurance Premium (through channels to State PTA by 12/20)Late Charge Insurance (assessed by State PTA if after 12/20)Workers Compensation Surcharge and form (throughchannels to State PTA by 1/31)Founders Day Freewill OfferingCouncil Assessments District PTA AssessmentsMembership EnvelopesCHECK # TOTAL$331 California State PTA Toolkit 2013