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Application worksheet

A printable version of South Taranaki District Council - Community Board Local Discretionary Fund's application questions, extracted from their official form. Use it to plan your answers - then submit through the funder's real form.

View the original PDF →

Application worksheet

Funding Accountability Report

South Taranaki District Council - Community Board Local Discretionary Fund

This worksheet mirrors the questions on the funder's official application form. It is NOT the official form. Submit your final answers through https://www.southtaranaki.com/our-community/funding/community-board-local-discretionary-fund.

This Funding Accountability Report must be submitted within three months after your project has been completed and before any further funding requests are made.

1. Attachment Details

Completed funding accountability report

Copies of receipts, invoices or bank statement showing funding spent

Photographs (if applicable)

Any other supporting documentation

2. Fund Details

Please check the appropriate fund for this Accountability Report*

Local Discretionary Fund
Tangata Whenua Liaison Fund
Waimate Plains Development Levy Fund
Perpetual Fund
Other

Amount received from the funding scheme:*

3. Section 1 – Applicant

Name of applicant:*

Project name:*

Start Date:*

End Date:*

Number of people who actively participated in your project:*

4. Section 2 – Project Report

Give a brief description of the highlights of your project What worked well? What didn’t work? What might you do differently next time? Are there any future plans for this project?*

5. Section 3 – Financials

Please give details of how the money was spent. Please account for the grant received, other grants received and your own financial contribution to the project.*

Project Costs: Item Detail Amount*

Total Costs:*

How did your project deliver to the project brief you provided?*

6. Section 4 – Project Income

Item Detail Amount*

Total Income:*

7. Section 5 – Other materials

Please attach copies of any of the following (if applicable): A summary of participant or audience survey results Newspaper articles or reviews Responses from other people involved in the project Responses to the project from other funding bodies or partners/supporters Photos of the project and/or event

Attached

Do we have permission to use these photos to promote South Taranaki District Council funding?*

Yes
No

Any comments/messages/additional information:

8. Section 5 - Declaration

I/we declare that we are a not-for-profit group (A not-for-profit does not earn profits for its members. All of the money raised or donated is used in pursuing the group’s objectives)*

I/we declare that the information supplied in this report is true and correct.*

I/we undertake that that I/we have obtained the consent of all people involved to provide these details.*

I/we understand that my/our organisation name and brief details about the project may be released to the media or appear in publicity material.*

I/we understand that the South Taranaki District Council is bound by the Local Government Official Information and Meetings Act 1987.*

I/we have used funding received solely for the project or purposes disclosed in our application.*

I/we have provided any receipts or invoices relevant to our project/event.*

9. Project report completed by

Name:*

Signature:*

Position in group:*

Date:*

Documents to attach

  • Completed funding accountability report
  • Copies of receipts, invoices or bank statement showing funding spent
  • Photographs (if applicable)
  • Any other supporting documentation

Worksheet generated by All Too Human (alltoohuman.nz/grants). Source: official PDF. This is not an official submission form.