PROJECT GRANT VARIATION AGREEMENT
Application ID:
Insert text here
PROGRAM GRANTS
FOR FUNDING COMMENCING IN 2017
CIA Surname:
Insert text here
 Each Chief Investigator (CI) on the Program Grant application must fill in this form.
 CIA must compile all forms into one pdf and upload to RGMS prior to close of round.
 If there are no excess Project Grants held by the CI, the form must still be completed.
(Please fill in electronically)
Title:
Name:
Program Grant APPID: APP
Program Grant CI Role:
Administering Institution:
STATEMENT OF CERTIFICATION (tick relevant response)
a) I certify that I have discussed and agreed with the affected researchers involved in
the Project Grant(s) listed at Section 1 that I will submit a grant variation request
for the nominated Project Grants I am no longer eligible to hold, should this
Program Grant application be successful. Moreover, I have obtained the signatures
at Section 2 of CIs agreeing to the Project Grant be retained (if applicable), should
this application be successful. ☐
OR
b) I certify that there are no excess Project Grants that will require the submission of
a grant variation request should this Program Grant application be successful. ☐
Signed: _______________________________
Date:
/ / 2015
Section 1 – Project Grants which will require the submission of a GRANT
VARIATION REQUEST
(copy entire table below for all excess Project Grants you hold. Please delete extra
rows if not required)
Project Grant: APP
Project Grant Role Title
CIA
First
Last
Signature of Authorisation
Section 2 - Project Grants to be RETAINED
(Please delete extra rows if not required)
Project Grant: APP
Project Grant Role Title
CIA
First
Last
Signature of Authorisation