Annual Donations Program - Acquittal of Donation Funding Form

At the completion of the project for which you have been provided funding by Council, you are required to complete this form. Please do not submit this form until the funds have been spent.

If the funds are not expended within the financial year, all funds MUST be returned to Council.

Preference for future donations will be given to organisations who submit this form by the due date.

Financial Year of Acquittal*

Details

Name of Organisation*

Name of Contact Person*

Position in Organisation*

Street Address*

Postal Address (if different to street address)

Suburb*

Postcode*

Contact Number*

Email Address*

Do you consent to Tamworth Regional Council updating their records with the information provided above?*

Amount of donation provided by Tamworth Regional Council*

Please provide a brief statement describing the use of the donation provided by Council*

Please upload receipt/s as evidence of funds spent*

Upload any additional documentation, if required

Authorisation

I certify that the information and documenation provided in this Acquittal Form is a true representation of the funds received and spent under the Tamworth Regional Council's Annual Donation Program*

Privacy Statement

Any personal information you have supplied to or is collected by Tamworth Regional Council will only be stored and processed by Council for lawful purposes directly related to the functions and activities of Council. Any personal information supplied will only be disclosed to a third party for the purpose of performing a lawful function or activity and for no other purpose. Disclosure of personal information to a third party will be in accordance with Tamworth Regional Council's Privacy Management Plan (PDF 331.7KB).

Mandatory field(s) marked with *