Community Grants Financial Acquittal and Feedback Form

= Required Fields

1. Grant Details

2. Financials

Any unspent grant funds must be returned to the Shire of Northam.

3. Project Evaluation

Was the project completed on schedule *

4. Declaration

I declare that the Shire of Northam Community Grant as specified above has been spent in accordance with the purpose and conditions for which it was granted. The attached financial acquittal and project evaluation are a true and correct record of the transactions and outcomes of the project.