Community Grants and Sponsorship

ACQUITTAL 2023-24
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Important Information

About your Acquittal Report

All grant recipients are required to complete an acquittal no later than 8 weeks after completion of the project. It is a condition of receiving a grant from Council and is a formal stage of the funding cycle. The Acquittal Report is how you account for the activities completed through the project utilising the grant funds.

The information contained in this Acquittal Report also helps Council to understand the nature of your project and the activities of your group and identifies future opportunities for collaboration in the support of your organisations activities and role in the community. Make sure that the information you supply in the Acquittal Report is accurate and respond to every question that relates to your funded activity.

Refer to your original application

It is your responsibility to ensure that all information and amounts recorded on the Acquittal Report and other related documents are accurate and can be accounted for. It is recommended that you refer to a copy of the original application you sent to Council in order to fill out your Acquittal Report.

Applicant Details

Organisation Name *

ABN *

GST Registered?

Postal Address *

Suburb *

State *

Postcode *

Phone Number *

Email Address *

Mobile Phone Number *

Contact Person

Auspice Details (if applicable)

Auspice Organisation Name

Auspice Organisation Address

Auspice Organisation Phone

Auspice Organisation Email

Auspice ABN

Registered for GST?

Details of Proposed Project, Activity or Event

Project Name *

Start Date *

End Date *

Funding Received *

Location/s of project *

Description of completed project, activity or event *

Which Strategies from Council's Ten Year Community Plan did the Project Meet and How?

(Select 1 per drop down box)

Explanation *

Acquittal Receipt Details

Provide a project budget -

Round all amounts to whole dollars;
Click 'add item' to list each purchase;
Note if an amount is provided in kind;
If you have applied for funding from other grants for the project, when listing these sources in Other funding, please note if it has already been approved.

Expenditure and income should be shown EXCLUSIVE of GST and totals for each should be the same (ie if cost is $2,000 ependiture should be $2,000). An example of how to calculate the project budget is included in the Community Grants and Support Program guidelines.

Income

Expenditure

Funding received *

Purchases

Applicant contribution

Contractors

Fundraising, donations, in-kind

Production/Promotional costs

Earned income (ticket sales)

Administration, salaries, fees, allowances

Total income

Total expenditure

Evidence of Funding Acknoledgement

Evidence of completed project, activity or event. Please provide no less than two high resolution images *

A Cook Shire Councillor was invited to attend any events, functions or project launches Councillor(s) invited:

Cook Shire Council was acknowledged in all media releases, advertising and promotion of the funded project, activity or event. *

KEY TERMS & CONDITIONS

Please read each statement below and sign to confirm your acknowledgement and agreement of these terms:

I certify that I have the information provided is a true and accurate record of the distribution of the Community Grants or Sponsorship funds and/or In-kind support.
I have read the guidelines relating to Cook Shire Council’s Communtiy Grants and Support Program and certify to the best of my knowledge the information provided in this form is correct and disclose full and accurate information of expenditure and activities proposed.

SIGNATURE

Signature *

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Date *

Name *

Organisation Position *

Auspicing Agreement (if applicable)

Please read each statement below and sign to confirm your acknowledgement and agreement of these terms:

I/my organisation agree/s to administer the grant that may be offered to the applicant on their behalf.
I understand that both the applicant and auspicing individual or organisation are considered responsible for ensuring the acquittal of grants and that both could be deemed ineligible to place further applications to Cook Shire Council until all grants have been satisfactorily acquitted.
I have read the guidelines relating to Cook Shire Councils Community Grants and Support Program and certify to the best of my knowledge the information provided in this form is correct and disclose full and accurate information of expenditure and activities proposed.
I certify that I have the appropriate delegation, as authorised by the auspice body.

Auspice Signature

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Date

Auspice Name

Auspice Organisation Position

Upload supporting documentation *

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Privacy Collection Notice

Cook Shire Council is collecting your name, residential address and telephone number in accordance with the Local Government Act 2009 in order to process your application. The information will only be accessed by employees and/or Councillors of Cook Shire Council for Council business related activities only. Your information will not be given to any other person or agency unless you have given us permission or we are required by law.

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