FILE ONE ORIGINAL (Two if you want a filed stamped copy returned to you.)FILING FEE: NO FEE TO FILE**** This supplement must be completed in its entirety, attached to the Unified Registration Statement **** and filed with the Secretary of State.1. Actual amount of funds received in the West Virginia during the last fiscal reporting year [see 24729-19-5(a)(6) ]:2. Actual disbursed for program services in West Virginia during the period covered in this report [see 24729-19-5(a)(6) ]: $ $ $ 3. Amount disbursed for program services outside West Virginia during the same period :Explain: 4. How much did the organization receive from government grants or private foundations during last year? $ WEST VIRGINIA UNIFIED REGISTRATION STATEMENT SUPPLEMENT Form URSS-1 Rev. 5/30/2018West Virginia Secretary of State Charities Division One Stop Business Center 1615 East Washington Street Charleston, WV 25311 Tel: (304)558-8000 Fax: (304)558-8381 Website: www.wvsos.gov Email: charities@wvsos.gov American LegalNet, Inc. www.FormsWorkFlow.com