= Required Fields

Online Form - Community Grant Financial Acquittal and Evaluation Form

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.

You are required to complete the statement of income and expenditure, unused funds (if applicable), schedule of donated materials and volunteer labour (if applicable) and to provide copies of invoices and / or other evidence of expenditure for all items expended with Shire of Northam funding.

Did the project commence on schedule *
Was the project completed on schedule *