Community Investment Fund Grant Accountability Form

Please complete the following accountability form for your Community Investment Grant. Forms cannot be saved so you will need to complete it in the one sitting.

Please ensure that you have copies of all required supporting documents before completing the form. On submission of your report, you will receive an automated response via email with a copy of your accountability report.

As reports are due 31 March, the last 3 months of the year will need to be forecast. Please advise if there are any changes from what you report following its submission.

1. Organisation Details

Name of organisation

Name of contact person

Phone number

Email address

2. Funding details

Please provide evidence that explains how your funding was spent.

Evidence upload (receipts, invoices, statements or photo)

Grant received (zero GST)

Date funding was received (month/year)

3. Reporting outcomes

Referring to your grant please explain how you have delivered on what you were funded to provide and the difference it made.

4. Signatory Sign Off

Our organisation has carried out the requirements of the grant to the best of our ability.

Please tick to confirm*

Full name

Position

Please note that we will be carrying out checks with 10% of funding recipients. This will involve a scheduled meeting with the organisation, with the intention of gaining a better insight into how funding has been spent to achieve outcomes.

Please answer this question:

Spell Nelson backwards.