The Rico Center Grant Application

Be prepared to have the required information before completing this grant report.

ü Photos, notices, postings, and/or other documentation displaying the grant project.

ü Receipts and invoices of all expenditures related to the grant project.

ü Any supplemental documentation requested on the award letter.

You must complete a separate grant report for each award.
This form must be signed and submitted by September 30th. Further grant requests from your organization may not be considered if this report is delinquent or incomplete.
You can save a draft of this form and come back to complete it later. Click "SAVE" at the bottom of any page and make sure to enter a valid email address, a link to return to your draft will be emailed to you. We encourage frequent saving to avoid losing your work.
What type of Grant Report are you submitting?
Annual Grant Reports are due September 31 of the award year. If grant projects are not complete at that time, a Supplemental Grant Report must also be submitted once the grant project is complete before January 31 of the following year.

Applicant Information
Organization Name*
Contact Name*

First NameLast Name
Position/Title *
Phone Number*
Email*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Organization Website

Project Information
Please refer to your orginal grant application to answer the following questions.
Project Name:*
Restate the grant project purpose:*
Have there been any changes to your organization’s IRS 501(c)(3) nonprofit status, or fiscal agent relationship since the grant project was awarded?*

NoYes
Please explain changes to IRS 501(c)(3), or fiscal agent relationship:*
Describe the goals and objectives of the grant project (as outlined in the grant application). Describe how these goals were achieved.*
Describe how the target population benefited from this grant project.*
How were the grant project and project outcomes shared with the community?*
Describe lessons learned, takeaways, or things that could have been done differently for the grant project.*
Will this program be continuing? What are the plans for sustaining or expanding the program? If the program is discontinued, what factors led to this decision?*
REQUIRED. Attach photos, postings, notices and/or documents displaying the grant project in the community.*

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If applicable, attach any documents requested as a condition in the grant project award letter.

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Since your Annual Grant Report was submitted, is there anything additional you'd like to share regarding the following topics: grant goals and objectives acheived, how the target population benefitted, how project outcomes were shared with community, lessons learned, takeaways, or things that could be done differently, sustaining or expanding the program, or anything else you'd like to share regarding the grant project.
Grant Funds Summary: Part I
Amount Awarded*
Amount Spent to date:*
Awarded Copy (Hidden)
Spent Copy(Hidden)
Are there any funds that are expected to be spent between when this grant report is completed and by the end of the grant year?*

NoYes
A supplemental grant report will be due by January 31st to report any grant project funds spent between the time of submission of this grant report and December 31 of this year. Please note that grant funds are awarded by calendar year. If the full grant amount has not been expended by December 31 of the grant year, all unspent funds must be returned to the Rico Center by January 31st of the following year. Please submit a NEW grant application for the next calendar year if you expect your grant project to require funds past December 31.
All unspent grant funds must be returned to the Rico Center by January 31st. Please note that grant funds are awarded by calendar year and no funds may be spent after December 31st. Please make checks payable to The Rico Center and mailed to PO Box 114 Rico, CO 81332.
Amount Expected to be Spend Between Now and December 31st:*
Amount Expected to be Spent (Hidden)
Describe expected expenditures:*

Grant Funds Summary: Part II
FOR SUPPLEMENTAL GRANT REPORTS - only expenses incurred since the Annual Grant Report was submitted are required. You do not need to submit duplicate expense information.
A summary of all expenses related to your grant project is required.
You must either upload or input manually the summary of expenses.

If the grant project contains more than 15 expenses you will be required to upload an excel spreadsheet.

Missing, incomplete, or undisclosed ineligible expenses may cause this grant application to be rejected and could disqualify your organization for future grant consideration.
Will you be uploading or manually inputting the expense summary?*

UploadManual
Your excel spreadsheet must contain the following columns:

Date, Amount, Description of Expense
Upload your excel spreadsheet summarizing all grant expenditures*

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Grant Funds Summary: Part III
You must provide the Rico Center with copies of all receipts and/or invoices for each expense incurred for the grant project.

Expenses and invoices must be uploaded below.
Please upload copies of all receipts and/or invoices for each expense incurred for the grant project. *

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WARNING: By submitting this application without uploading receipts or invoices this grant report may be considered incomplete and a failure to meet the conditions detailed in the Grant Award. Failure to meet the Grant Conditions may result in the return of grant funds and/or disqualification from future grant awards.

Optional: Additional Information or Comments
Please share with us any feedback you have for the grant application and/or grant reporting process.

Agree & Sign
APPLICANT ORGANIZATION CERTIFICATION AND ACCEPTANCE: I certify that the statements herein are true, complete and accurate to the best of my knowledge.
Signature*

Clear
Name*

First NameLast Name
Date*

MonthDayYear
Date
Should be Empty:

	Date	Amount	Description of Expense
I
II
III
IV
V
VI
VII
VIII
IX
X
XI
XII
XIII
XIV
XV

Be prepared to have the required information before completing this grant report.

Applicant Information

Project Information

Grant Funds Summary: Part I

Grant Funds Summary: Part II

Grant Funds Summary: Part III

Optional: Additional Information or Comments

Agree & Sign