Entity Annual Report Form Indiana PDF Details

In Indiana, entities are required to file an Annual Report with the State Board of Accounts, a process facilitated through Form E-1, otherwise known as the Entity Annual Report. This document plays a critical role in determining the audit requirements for organizations as mandated by IC 5-11-1-9. Entities must submit this report within thirty days following the end of their fiscal year. The State Board of Accounts, located at 302 West Washington Street in Indianapolis, provides instructions to aid in the completion of this form. Essential details such as the legal name, type of organization, and financial information regarding government funds received and disbursed throughout the year are required fields on the form. Additionally, entities are prompted to declare the basis (cash or accrual) on which the report is prepared. The form serves multiple purposes, including certification that the information provided is accurate and detailed reporting of government funds received. Entities must also describe their organizational structure, purpose, and indicate whether they have previously been audited by an Independent Public Accountant. This comprehensive form ensures entities maintain transparency about their financial dealings and organizational structure, adhering to state regulations.

QuestionAnswer
Form NameEntity Annual Report Form Indiana
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdisbursements, accrual, WASHINGTON, E-1

Form Preview Example

ENTITY ANNUAL REPORT

STATE BOARD OF ACCOUNTS

 

 

302 WEST WASHINGTON STREET

Form E-1 (2-07)

ROOM E418

Prescribed by State Board of Accounts

INDIANAPOLIS, INDIANA 46204-2765

Note:

The Entity Annual Report (Form E-1) is used to determine

Telephone: (317) 232-2513

 

the audit requirements placed on your entity by IC 5-11-1-9

Fax: (317) 232-4711

 

File report within thirty (30) days of the close of your entity's

Web Site: www.in.gov/sboa

 

fiscal year end. Instructions for completing Form E-1 are

 

 

included in the attached memorandum

Page 1 of 2

Entity's Fiscal Year End

______ ______ ______

Month Day Year

OFFICE USE ONLY

SBA NO: _____________

Audit Determination:

____________ Complete

____________ Waived

Legal Name:

 

Federal ID No:

 

 

 

 

D/B/A:

 

Business Phone No: ( )

 

 

 

 

Street Address:

 

 

 

 

 

 

 

City:

County:

State:

Zip Code:

 

 

 

 

Name of Operating Officer:

 

Title:

 

 

 

 

 

TYPE OF ORGANIZATION

LEGAL STATUS

 

 

 

 

_________ Corporation

_________ ASSOCIATION

_________ For Profit

 

_________ Partnership

_________ INDIVIDUAL

_________ Not-For-Profit

 

 

 

 

 

 

 

 

FINANCIAL INFORMATION

 

 

 

 

1.

Government funds received during year (Detailed on Page 2)

$__________________

2.

Government funds disbursed during year

 

$__________________

3.

Entity's total disbursements (or expenditures) for the year

$__________________

4. Percent of government funds disbursed to entity's total

 

 

 

disbursements (or expenditures) (Line 2 / 3)

_________________ %

This information is reported on the ___________ cash basis ___________ accrual basis.

 

 

 

 

 

 

 

 

 

 

 

Is this the initial Form E-1 filing for the entity? Yes

__________ No

__________

 

 

 

 

 

 

CERTIFICATION: This is to certify that the data contained in this report is accurate to the best of my

knowledge and belief.

 

 

 

Signature:________________________________

Title __________________________

Printed Name: ____________________________

Date Signed: ___________________

Page 2 of 2

DETAIL OF GOVERNMENT FUNDS RECEIVED

List the government funds received during the year by agency, address, program title and amount received. Attach additional sheets if necessary.

GOVERNMENT AGENCY

ADDRESS

PROGRAM TITLE

AMOUNT RECEIVED

Date organization was founded: _________________________________________________________________

Describe organization's purpose:_________________________________________________________________

___________________________________________________________________________________________

Describe organizational governing structure:________________________________________________________

___________________________________________________________________________________________

Have you ever been audited by an Independent Public Accountant (IPA)? Yes ___________ No ___________

If so, what was the last fiscal year audited? ________________________________________________________

Name and address of IPA that conducted audit: _____________________________________________________

___________________________________________________________________________________________

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accrual writing process clarified (part 2)

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