AEHC County Treasurer’s Report Form	FCS 748 11-2016
County Name:	District:
County Council Treasurer’s Name:
Address:
City:	State:	Zip Code:
Telephone Number, Including Area Code:
E-mail Address:
Dues shall be paid to the Treasurer of the Council annually by August 1. Dues become delinquent after September 1, and a County Council whose dues are delinquent thereby forfeits all rights to vote at any board meeting during that fiscal year. If the annual dues are not paid by October 1 of the fiscal year, that County Council shall not be considered a member and will not be listed as such the following year. A County Council may be reinstated by sending an application to the State President for approval by the Executive Committee. This application must be accompanied by payment of all delinquent dues.
DUES – Send one check to the State Treasurer (made payable to AEHC) for club dues, member dues, and any contributions. The County Treasurer will receive a letter of confirmation when all dues are paid. Complete the General Data Form and submit with dues.
A. Club Dues– $5.00 per club per year
Number of Clubs X $5.00	$0.00
B. Member Dues – $4.00 per member per year
Number of Members X $4.00	$0.00
C. Member at Large Dues – $4.00 per member per year
Number of Members at Large X $4.00	$0.00
D. Contributions
Pennies for Friendship	$0.00
Total Remitted (Sum of Lines A, B, C, and D)	$0.00
Send this form along with one check and the general data form (G9) to: Carolyn Morris, treasurer PO Box 275 Danville, AR 72833 The University of Arkansas System Division of Agriculture offers all its Extension and Research programs to all eligible persons regardless of race, color, sex, gender identity, sexual orientation, national origin, religion, age, disability, marital or veteran status, genetic information, or any other legally protected status, and is an Affirmative Action/Equal Opportunity Employer.