R OLLESTON COAL COMMUNITY BENEFIT FUND

R OLLESTON COAL COMMUNITY BENEFIT FUND




ROLLESTON COAL

RR OLLESTON COAL COMMUNITY BENEFIT FUND OLLESTON COAL R OLLESTON COAL COMMUNITY BENEFIT FUND

Community Benefit Fund


* * *

Acquittal of Grant



  1. Name of Organisation: _______________________________________________


  1. Project: ___________________________________________________________


  1. Grant Approved: $ _______________


  1. Funds Expended:

___________________________________ $ _______________

___________________________________ $ _______________

___________________________________ $ _______________

___________________________________ $ _______________

___________________________________ $ _______________


___________________________________ $ _______________


TOTAL $ _______________



Details must be supported by invoices (attach to this form). Any money not expended must be returned to the Community Benefit Fund.




  1. Signature of responsible officers (President, Secretary, Treasurer etc.)


Name: _________________Title: ________________ Signature: _______________


Name: _________________Title: ________________ Signature: _______________


Dated: ____________________



RCCBF Office Use Only

Funds Returned:


Date: _______________ Receipt Number: ______________ Signature: __________________





Tags: benefit fund, community benefit, benefit, olleston, community