Online Form - Acquittal Report- Community Growth Fund Please complete this form once your Community Growth Fund project is complete. Please supply the Shire of Chapman Valley with an invoice for the Community Growth Fund by no later than the third Friday in June. Grant Operational Procedures are available at request. If your grant has specific grant conditions applied, these would have been outlined in your approval letter. Once the form has been submitted, a Shire officer will process it for grant reimbursement as per the Community Growth Fund Procedure. Applicant:* * Required Field. Project Name:* * Required Field. 1. Please provide a summary of the project initiatives met as per your original application 2. Describe any changes to your project. (Reasons and how they affected your project) 3. What other people, groups or organisations did you work with on your project? 4. How were your project outcomes measured? 5. Please complete income and expenditure details for your grant (excluding GST). Include other funding sources and In-kind contributions. Income and expenditure totals should equal the same amount. 6. Please upload evidence of expenditure (invoices, receipts) Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx 7. Upload an invoice from your organisation to the Shire for your grant amount. Max File Size: 10.00 MB Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx DECLARATION .* The information in this form is correct and accurate at the time of submitting. I have uploaded an invoice to ensure prompt reimbursement of my grant funding DECLARATION <br> Name:* * Required Field. Position in Organisation:* * Required Field. Date* * Required Field. Type the code from the image: Do not fill this textbox.