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CR-2 43, 0 4 /0 5 A nn ual R eport o f C rim e P re ve ntio n O rg aniz a tio n ( P riv a te N on -P ro fit O rg a niz a tio n ) §75 7.1 7, W is co nsin S ta tu te s T h is f o rm s h all n ot b e m odif ie d . It m ay b e s u pple m en te d w it h a d dit io nal m ate ria l. P age _ _ _ o f _ __ S TA TE O F W IS C O NSIN , C IR CUIT C O URT A nnual R ep ort o f C rim e P re ve n tio n O rg an iz a tio n (P riv ate N on-P ro fit O rg an iz a tio n) F or O ff ic ia l U se T O : TH E C LE R K O F C O URTS F O R C O UN TY N am e o f c rim e p re ve ntio n o rg aniz a tio n Addre ss F R O M : Em plo ye r I. D . n um ber Tax e xe m pt n um be r N ote : A c rim e p re ve n tio n o rg an iz a tio n is d efin e d in § 973 .0 6 (1 )(f) 1 .a ., W is c o nsin S ta tu te s a s “ A p riv a te n on pro fit o rg an iz a tio n w hic h h as a s it s p rim ary p urp ose p re ve ntin g c rim e, e nco ura g in g th e p ub lic to r e p ort o r a ssis tin g la w e nfo rc e m ent in th e a p pre he nsio n o f c rim in al o ffe nders ” ( e m phasis a dded). A c o py o f y o ur o rg an iz a tio n ’s A rtic le s o f In co rp ora tio n, B y-la w s o r o th er in stit u tio n al d ocu m enta tio n s e tt in g f o rth a p rim ary p urp ose c o nsis te n t w it h t h e s ta tu to ry d efin it io n m ust b e a tta ch ed t o th is r e port. R E: Ann ua l r e port o f c o ntr ib utio ns r e ce iv e d a nd e xp e ndit u re s m ade r e quir e d p urs u ant to , § 757.1 7 , W is co nsin S ta tu te s f o r th e c a le ndar y e ar 2 . 1 . The o ff ic e rs o f th is c rim e p re ve ntio n f u nd a re : NAM E O F O FFIC ER OFFIC E H ELD (A tta ch a dd it io na l lis t if m ore o ff ic e rs .) 2 . Durin g th e r e portin g p erio d , c o ntr ib utio ns in th e to ta l a m ount o f $ w ere m ade to t h e o rg an iz a tio n a s s e t f o rth in S ch ed ule A , a tt a ch ed. ( A tt a ch a s m an y s h ee ts a s n ece ssa ry .) Annual R ep ort o f C rim e P re v en tio n O rg an iz a tio n ( P riv ate N on-P ro fit O rg an iz a tio n) Pag e _ _ _ o f _ _ _ C R-2 43, 0 4 /0 5 A nn ual R eport o f C rim e P re ve ntio n O rg aniz a tio n ( P riv a te N on -P ro fit O rg a niz a tio n ) §75 7.1 7, W is co nsin S ta tu te s. T h is f o rm s h all n ot b e m odif ie d . It m ay b e s u pple m en te d w it h a d dit io nal m ate ria l. P age _ _ _ o f _ __ 3 . Durin g th e r e portin g p erio d , e xp en dit u re s in th e to ta l a m ount o f $ w ere m ade b y th e o rg an iz a tio n a s s e t f o rth in S ch ed ule B a tta ch ed. ( A tt a ch a s m an y s h eets a s n ece ssa ry .) These e xp end it u re s m eet t h e p rim ary p urp ose s o f th e c rim e p re ve ntio n o rg an iz a tio n a s s e t f o rth in t h e s ta tu to ry d efin it io n b eca use : 4 . The a m ount o f c o ntr ib utio n s r e m ain in g in th e c rim e p re ve ntio n f u nd f r o m th e p rio r c a le n dar y e ar w ere $ . 5 . The a m ount o f c o ntr ib utio n s r e m ain in g in th e c rim e p re ve ntio n f u nd a s o f th e c lo sin g d ate o f th is r e port is $ . 6 . I c e rtif y th at I h a ve p re pare d th is r e port a nd th at th e in fo rm atio n in clu de d in t h e r e port is c o m ple te a nd accu ra te . N am e o f p re p are r D aytim e t e le ph one n um ber Addre ss Sig natu re o f p re pare r D ate Annual R ep ort o f C rim e P re v en tio n O rg an iz a tio n ( P riv ate N on-P ro fit O rg an iz a tio n) Pag e _ _ _ o f _ _ _ C R-2 43, 0 4 /0 5 A nn ual R eport o f C rim e P re ve ntio n O rg aniz a tio n ( P riv a te N on -P ro fit O rg a niz a tio n ) §75 7.1 7, W is co nsin S ta tu te s. T h is f o rm s h all n ot b e m odif ie d . It m ay b e s u pple m en te d w it h a d dit io nal m ate ria l. P age _ _ _ o f _ __ S ch ed ule A Nam e o f C ontr ib uto r/D efe n dan t Bra n ch N um ber o f C ou rt R eq uir in g C ontr ib utio n A m ount Annual R ep ort o f C rim e P re v en tio n O rg an iz a tio n ( P riv ate N on-P ro fit O rg an iz a tio n) Pag e _ _ _ o f _ _ _ C R-2 43, 0 4 /0 5 A nn ual R eport o f C rim e P re ve ntio n O rg aniz a tio n ( P riv a te N on -P ro fit O rg a niz a tio n ) §75 7.1 7, W is co nsin S ta tu te s. T h is f o rm s h all n ot b e m odif ie d . It m ay b e s u pple m en te d w it h a d dit io nal m ate ria l. P age _ _ _ o f _ __ S ch ed ule B Nam e o f R ecip ie n t o f E xp en dit u re Am ount o f E xp en d it u re