QPFD Annual Report "*" indicates required fields Step 1 of 3 33% Please use one of the following web browsers to complete this form: Google Chrome, Microsoft Edge, or Firefox.For Fiscal Year End*Select an FY End04/30/202305/31/202306/30/202308/31/202309/30/202310/31/202312/31/202303/31/2024SCHEDULE A - GENERAL INFORMATIONQPFD's Name* Full Legal NameQPFD's Mailing Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Person* First Last Contact Email* Contact Phone* SCHEDULE B - PUBLIC DEPOSITORS*Please upload a listing or describe below the following information for all Mississippi Public Depositors that have accounts with the QPFD (including Public Depositors that have accounts with zero balances). Upload report Fill in form File upload* Drop files here or Select files Accepted file types: pdf, Max. file size: 10 MB, Max. files: 12. Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #2 Add Depositor Hidden2.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #3 Add Depositor Hidden3.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #4 Add Depositor Hidden4.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #5 Add Depositor Hidden5.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #6 Add Depositor Hidden6.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #7 Add Depositor Hidden7.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #8 Add Depositor Hidden8.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #9 Add Depositor Hidden9.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #10 Add Depositor Hidden10.Tax ID Public Depositor* Deposit Account Name* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Number* Account Balance*Add Depositor #11 Add Depositor Hidden11.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #12 Add Depositor Hidden12.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #13 Add Depositor Hidden13.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #14 Add Depositor Hidden14.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #15 Add Depositor Hidden15.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #16 Add Depositor Hidden16.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #17 Add Depositor Hidden17.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #18 Add Depositor Hidden18.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #19 Add Depositor Hidden19.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance*Add Depositor #20 Add Depositor Hidden20.Tax ID Public Depositor* Deposit Account Name* Account Number* Account Type*Select an account typeDemandTimeCertificate of DepositAccount Balance* SCHEDULE C - VERIFICATION WE VERIFY that we have: 1. Provided annual confirmation to Public Depositors of all the open Mississippi Public Deposit accounts as of their fiscal year end. All discrepancies found in the confirmation process were reconciled within 60 days after their fiscal year end. Information supplied to public depositors included the following: a.) Tax ID of the QPFD b.) Name on the deposit account record c.) Tax ID on the deposit account record d.) Account number e.) Account type f.) Actual balance on deposit 2. Executed the Collateral Security Agreement, as needed, for each public depositor 3. Properly identified and uniquely coded on our deposit account records all open Mississippi Public Deposit accounts and have reported and collateralized these accounts as required by Mississippi Code Section 27-105-5. 4. Provided, as part of this report, a listing of all Mississippi Public Depositors that have accounts held by this financial institution. This filing has been completed in the report format prescribed by the State of Mississippi, Office of the State Treasurer for this year. ELECTRONIC SIGNATURE REQUIRED* Under penalties of perjury, I attest that I am authorized to sign on behalf of the QPFD identified above, and also declare that I have read the information provided on this Qualified Public Funds Depository Annual Report and that the facts stated in it are true to the best of my knowledge and belief.Signature*
