Online Acquittal Form Step 1 of 4 25% I - Applicant Details1. Name* First Last 2. Email* 3. Phone*4. Business Name* 5. Business Address* Street Address Postal Address (if different) Town Post Code II - Project Evaluation6. Briefly describe the project that you undertook through this funding.*7. Project's start date* Day Month Year 8. Project's end date* Day Month Year 9. Were there any significant changes from the outline you described in your original application?*(project activities, anticipated benefits and impact from the project, any unexpected benefits that this funding provided, etc.) Yes No Untitled*10. In evaluating your funded project, is there anything that you would have done differently? If so, please explain.*(project activities, anticipated benefits and impact from the project, any unexpected benefits that this funding provided, etc.) Yes No Untitled*11. How have you acknowledged the Yorke Peninsula Council for the funding you received?* III - Financial Information12. Complete the table below about the income and expenditure of the funded project*. Income Item Amount*Item Your contribution*Item Income from other sources (e.g. other grants)* Income Total Income Total Expenditure Item* Amount*Expense item Expense 2Expense item Expense 3Expense item Expense 4Expense item Expense 5 Expenditure Total Income Total NET Number13. Attach all relevant documentation that supports this expenditure*(i.e., invoice(s) from suppliers/contractors and corresponding proof of payment i.e., receipt of invoice). If per your Letter of Offer/Funding Agreement, you are being reimbursed (rather than paid up front), please attach your Tax Invoice from your business to Yorke Peninsula Council for the approved amount. Drop files here or Select files Max. file size: 500 MB. 14. Certification of financial reconciliationIf specified in your Letter of Offer/Funding Agreement that you must provide an opinion or certification by an independent auditor to verify that your financial reconciliation is true and correct, please upload your certified statements here. Drop files here or Select files Max. file size: 500 MB. IV - Additional Information15. How did you find the business grant process?16. Do you have any other comments that you would like to add?DeclarationUntitled* I declare that all details supplied in this evaluation report are true and correct to the best of my knowledge.