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ATTACHMENT 5: FORM OF UNAUDITED FINAL FINANCIAL REPORT

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ATTACHMENT 5: FORM OF UNAUDITED FINAL FINANCIAL REPORT

Project Expenses for [Acronyms of the Competition]-funded Activities for Project Implementation Period

Project Budget Summary
	First Grant Disbursement	Second Grant Disbursement	Third Grant Disbursement
Sources of Funds
1. Grant	$100,000
2. Other Funds:
(a) Revenue generated from project
(b) Other Donors
Total Project Funds	0.00	0.00	0.00

Budget for Grant Funds
I. Use of Grant Funds
A. Works
Purchase of ojoche seed	$ 9,234
Setting up of the greenhouse	$ 7,500
Setting up the cultivation of ojoche	$8,000
Collecting input for nutrition baseline	$300
Design of nutrition baseline assessment	$500
Purchase of ingredients for snacks and workshops	$25,000
Design of a monitor and evaluation assessment	$300
Sub-total:	$50,834
B. Goods (Materials and Equipment)
Purchase of computer and printer	$1,500
Materials for greenhouse	$3,241
Purchase of wire and staple for fence	$10,000
Sub-total:	$14,741
C. Services:
(1) Staff salaries	$22,000
(2) Consultant fees	$3,000
(3) Travel (consultant and staff)	$4,500
Sub-Total:	$29,500
D. Operating Costs
Office Lease	$3,500
Utilities (electricity, gas, water)	$225
Printing, photocopies	$1,200
Sub-total:	$4,925
E. Other (please specify)
Subtotal: Use of Grant Funds	$100,000	0.00	0.00
II. Use of Other Funds (revenue generated + other donors)
Total Use of Funds	0.00	0.00	0.00

1 Instruction to the Recipient when sending this letter to the World Bank: Stipulate if more than one person needs to sign Applications, and how many or which positions, and if any thresholds apply. Please delete this footnote in final letter that is sent to the World Bank.

2 Instruction to the Recipient: Stipulate if more than one person needs to jointly sign Applications, if so, please indicate the actual number. Please delete this footnote in final letter that is sent to the World Bank.

3 Instruction to the Recipient: Use this bracket if any one of the authorized persons may sign; if this is not applicable, please delete. Please delete this footnote in final letter that is sent to the World Bank.

4 Instruction to the Recipient: Use this bracket only if several individuals must jointly sign each Application; if this is not applicable, please delete. Please delete this footnote in final letter that is sent to the World Bank.

5 Instruction to the Recipient: Add this paragraph if the Recipient wishes to authorize the listed persons to accept Tokens and to deliver Applications by electronic means; if this is not applicable, please delete the paragraph. Please delete this footnote in final letter that is sent to the World Bank.

6 “Bank” includes IBRD and IDA.

7 “Borrower” includes the borrower of an IBRD loan, IDA credit, or Project Preparation Facility advance and the recipient of a grant.

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