STATE OF UTAH - DIVISION OF CONSUMER PROTECTION
                                     STATEMENT OF FUNCTIONAL EXPENSES
              For organizations who file the IRS Form 990-EZ, 990-PF, 990-N, or do not file any type of IRS Form 990

                                          ORGANIZATION NAME

                                              Revenue
Contribution/Grant Revenue                                                                                          0.00
Other Revenue                                                                                                       0.00
Total Revenue                                                                                                       $ 0.00

                                              Expense
                                              A                                  C                
                                                                B                                                   D                
   Do not report amounts reported on other    Total                              Management & 
                                                                Program Service                                     Fundraising
                    lines                     Expenses                           General
1 Grants, Allocations, Contributions Made     0.00              0.00
2 Specific Assistance to Individuals          0.00              0.00
3 Registration Fees                           0.00                                      0.00
4 Benefits Paid to/for Members                0.00              0.00                    0.00                        0.00
5 Compensation of Officers/Directors          0.00              0.00                    0.00                        0.00
6 Employee Salaries and Wages                 0.00              0.00                    0.00                        0.00
7 Pension Plan Contributions                  0.00              0.00                    0.00                        0.00
8 Other Employee Benefits                     0.00              0.00                    0.00                        0.00
9 Payroll Taxes                               0.00              0.00                    0.00                        0.00
10 Legal Fees                                 0.00              0.00                    0.00                        0.00
11 Accounting Fees                            0.00              0.00                    0.00                        0.00
12 Lobbying Fees                              0.00              0.00                    0.00                        0.00
13 Professional Fundraising Fees              0.00              0.00                    0.00                        0.00
14 Investment Management Fees                 0.00              0.00                    0.00                        0.00
15 Bank Fees                                  0.00              0.00                    0.00                        0.00
16 Advertising and Promotion                  0.00              0.00                    0.00                        0.00
17 Office Expenses                            0.00              0.00                    0.00                        0.00
18 Information Technology                     0.00              0.00                    0.00                        0.00
19 Royalties                                  0.00              0.00                    0.00                        0.00
20 Occupancy                                  0.00              0.00                    0.00                        0.00
21 Travel                                     0.00              0.00                    0.00                        0.00
22 Conferences, Conventions and Meetings      0.00              0.00                    0.00                        0.00
23 Interest                                   0.00              0.00                    0.00                        0.00
24 Payments to Affiliates                     0.00              0.00                    0.00                        0.00
25 Insurance                                  0.00              0.00                    0.00                        0.00
26 Other Expenses                             0.00              0.00                    0.00                        0.00
27 Total Functional Expenses                  $0.00             $ 0.00           $ 0.00                             $ 0.00

                                     Application Financial Information
B Contributions                                                                                                     0.00
C Management & General Expense                                                                                      0.00
D Fundraising Expense                                                                                               0.00

E Fundraising Costs as % of contributions                                                                           0%
F Fundraising + Mgmt as % of contributions                                                                          0%
G % of contributions remaining for charitable                                                                       0%