Grant Acquittal

Grant acquittal
Congratulations on completing your project.

Please use this form to acquit your project funded under the Community Project Grant, Community Halls Support Program or the Community Volunteer Support Program.

Under the guidelines for these grant programs it is your responsibilty to ensure the project is completed and that all related documents as requested on this form are provided to succesfully acquit the grant.

All Lower Eyre Council grant money not used for the project must be refunded back to Council.

All receipts and / or tax invoices relating to the project funded by these programs need to be uploaded with the form.

If you require advice on how to complete this form, please contact Lower Eyre Council.

Telephone: (08) 8676 0400

Email: mail@lec.sa.gov.au
Part A - Applicant Details
Which program did you receive funding from?*

Community Project GrantCommunity Halls Support ProgramCommunity Volunteer Support Grant
Name of organisation*
Organisation's address

Postal Address

Postal Address Line 2

CityState

Post Code
Contact person*
Position in organisation*
Email*
example@example.com
Phone Number (day time)*
Please enter a valid phone number.
Phone Number (after hours)
Please enter a valid phone number.
Part B - Project Details
Project Title*
Project location (Where did your project occur?) *

Location Address

Location Address Line 2

CityState

Post Code
Project start date*

DayMonthYear
Date
Project completion date*

DayMonthYear
Date
YesNo
YesNo
Please tell us about any changes that were made to your project and why they were needed?
This could include reasons for a delay in completing the project, or why the scope of the project changed. Please give a brief reason for these changes.
Please upload a copy of your written approval from Lower Eyre Council agreeing to the changes to your project.

This may be an email or a letter from Council acknowledging the changes to your project or approving an extension of time to complete works.
Cancelof
What did your project achieve?*
Tell us how you spent the grant money, what was achieved, how the project benefited the community.
How was Lower Eyre Council's funding acknowledged?*
Tell use how you publicly acknowledged the grant through a newsletter, social media, sponsors board or other promotion.
Please upload examples of your public acknowledgment of this grant. *

This may be a screenshot of social media posts, copies of your newsletter, or a photograph of a sponsorship board.
Cancelof
Part C - Financial Acquittal
What was the total cost of the project? *
Dollar amount
What was your total income for the project?*
Dollar amount
Council grant
Project costs*
Project income*
Upload invoices for costs here*

To complete your acquittal these must be provided. Where you have used donated materials or in-kind labour, provide a breakdown of the activity and a dollar value of the contribution.
Cancelof
Please provide photographs of your project*

These could be photographs taken during construction, of the completed project, or an official opening. By uploading an image your organisation and any people in the photograph agree to its publication as they may be used on Council's website, social media or newsletters.
Cancelof
Part D - Declaration
Declaration

Please read the following conditions and tick the checkboxes. If your application is incomplete you may be required to resubmit it.

If you are required to repay unspent funds Lower Eyre Council will contact you via the email provided with this form.
Print Name*
Organisation*
Position*
Email*
example@example.com
Signature*

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Date*

DayMonthYear
Should be Empty:

Grant acquittal

Part A - Applicant Details

Part B - Project Details

Part C - Financial Acquittal

Part D - Declaration