Grant Acquittal Form

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The Secretary to the Cultural Committee
c/- Marketing and Communications Division
The University of Waikato
Private Bag 3105
Hamilton, New Zealand
Email: Culturalcom@waikato.ac.nz
www.waikato.ac.nz
Email: culturalcom@waikato.ac.nz
www.waikato.ac.nz
ACQUITTAL REPORT
Grant recipient
Amount of grant
Purpose of grant
Date
ACQUITTAL OF YOUR GRANT
It is a condition of your grant that you provide the Cultural Committee at the conclusion of your project with
the following:
A brief artistic report; and
A financial report (statement of income and expenditure)
Please follow the attached formats for your artistic and financial reports. You may attach further pages if
you wish to provide additional detail or explanation. External organisations need to provide copies of
receipts to the funded amount.
Acquittal reports are to be submitted to The Secretary of the Cultural Committee at the above email
address as soon as possible after the event. An acquittal report must be submitted for eligibility of further
funding.
1.
ARTISTIC REPORT AND SUPPORT MATERIAL
1.1
Please provide a brief event summary.
1.2
Where appropriate include illustrative material. This material should relate closely to the project or
activities. Please note: if any of your material is to be used by the Cultural Committee, your permission will
be sought first.
Please indicate in the table below the material you have included:
Copies of all programmes
Manuscripts
Posters
1.3
Photographs
Newspaper advertisements
Video
Promotional material
Published books(s)/articles
Others, please specify:
Please include/attach audience responses or participant feedback to your project.
Indicate in the table below any responses or feedback that you have attached.
Audience responses.
Responses from other people involved in the project or related activities in the form of a peer review.
Responses to the project/activities from other funding bodies.
Responses to the project from host organisations.
Media coverage or criticism.
Others, please specify:
1.4
In the table below, indicate where any additional documentation can be accessed. This
documentation may include videos, slides, catalogues, musical scores, etc, relating to the project or
activities. Also record the nature of the material, brief details and current location.
Medium
2.
Title/comments
Location
SUMMARY INFORMATION
Information recorded in this section is used by the Cultural Committee to monitor the effectiveness of the
grant programmes. Please complete those questions, which are relevant to your project or activities.
2.1
Was new artistic work created as a result of the project/activities: (New artistic work may
include, but need not be limited to manuscripts, scripts, musical works, dance works, painting,
sculpture, craft works.)
Yes
No
If you answered yes, please list in the table below the titles of these works together with brief details
about the type or nature of these works. Also give the total number of new artistic works created in
the space provided.
Work created (title)
Type or nature of work
Total number of new works created:
2.2
Was artistic work presented/promoted/recorded/exhibited/published as a result of
project/activities:
Yes
No
If you answered yes, also give the total number of works
presented/promoted/recorded/exhibited/published in the space provided.
Title of work
Type or nature of work
Total number of works presented:
2.3
Audience details:
(a)
Did the project/activities have a public outcome?
Yes
No
(b)
If you answered yes, please describe the outcome (eg. an exhibition, tour, publication,
theatre production etc):
(c)
Provide a breakdown of the audience numbers using the table below:
Performance One
Performance Two
Performance Three
Total audience size:
2.4
Groups benefiting from your project or activities:
The purpose of this section is to gain information about particular groups or communities, which may gain
skills, opportunities, resources or other benefits from the outcomes of your project.
Record in the table below groups/communities that derived significant benefits from your project, or to
whom your project was directed. If you wish describe briefly the benefits to each group, such as access to
artistic activities or performances, employment or involvement in artistic activities or performances.
University students
Regional communities
Emerging artists
Young people (under 26 years of age)
Hamilton residence
Other, please specify:
2.5
University staff
People with an intellectual disability
Women
People with a physical disability
Iwi
No specific group
Details of professional artists and arts workers:
Record in the table below, names and positions/roles of all professional artists and arts workers employed
or engaged in the project or activities.
NAME
Total number of artists/arts workers employed
POSITION/ROLE
3. FINANCIAL REPORT
Provide a statement of income and expenditure for the project/activities using the excel spread sheet
available at: www.waikato.ac.nz/cultural-committee/apply_for_funding
SURPLUS / (DEFICIT)
$ 0.00
Surplus/Deficit:
If there is a financial surplus or deficit, please indicate in the space below either,
(a)
how the surplus funds will be used, or
(b)
how the financial loss will be covered
Please note: There is an expectation that profits will be returned to the Cultural Committee unless otherwise
agreed in advance.
Certification:
I certify that the grant was used for the approved purpose(s). To the best of my knowledge and belief the
Statement of Income and Expenditure covering the grant is true and fair.
Signed: ________________________________________
Individual recipient/grantee of the organisation
Date: ________________________
GENERAL GUIDELINES FOR COMPLETING THE FINANCIAL REPORT
(a)
A grant recipient must provide, at the conclusion of the project/activity, a Statement of Income and
Expenditure showing the grant payment as a separate and identifiable item and showing how the
grant was spent.
(b)
The Income and Expenditure Statement is designed to accommodate a variety of grant categories.
Some classifications of income and expenditure may not be applicable for your project, or you may
need to include additional headings in your statement.
(c)
This statement should be prepared on a cash basis and include only income and expenditure items
that are relevant to the project funded by the Cultural Committee.
(d)
Amounts should be provided exclusive of GST for Internal (University Departments) and inclusive
of GST for External Organisations
INCOME
(a)
Itemise each grant, and identify the Fund/Board providing the grant.
(b)
Identify and itemise all national and local government grants.
(c)
‘Direct production income’ should include box office, performance and exhibition income.
(d)
Detail types of income received and not covered in the classifications of income on the space
provided under ‘Other income’.
EXPENDITURE
(a)
All wages, salaries, fees and associated costs incurred should be classified under the heading of
‘Wages salaries and fees’. Any artist’s payments should be itemised to show the individual or
groups payment. Where an artist also performs other work, eg. assisting with administration, the
remuneration should nevertheless be fully classified as artist’s wages and salaries.
(b)
‘Direct production costs’ include all costs directly related to activities (eg. venue or theatre costs,
technical equipment, sets, props, costumes, royalties, commissions, exhibition costs, workshop
costs, lecture costs, etc. but exclude wages and salaries, promotion and administration costs).
(c)
‘Promotion costs’ include media and other costs (excluding wages) involved in the promotion of
activities.
d)
‘Administration costs’ should include all general administrative type costs (eg, bank charges,
cleaning, electricity, printing, stationery, rent, postage, telephone, travel, freight).
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