Online Form - Annual & Rates Assistance Grants - Acquittal Form


To be completed within 12 months of the grant being approved at an Ordinary Council Meeting.

Acquittals that are incomplete, or fail to adequately recognise the Shire's contribution will be noted and may be considered when assessing future Shire grant applications. 


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Note: Incomplete forms are kept for a period of 2 day(s) , after this time the system will automatically delete your response.

Contact Details


Please outline the key achievements of the project / event.


Please outline how the Shire of Wyndham East Kimberley Annual Community Grant funds were spent using the below Project Budget Template. Please include all details and upload the completed document.

Project Budget Template

Please note. Your total income should equal your total expenditure. 

***Any unused Annual Community Grant funds must be returned with this acquittal report

Copies of all receipts over $1000 must be attached. Please attach copies below:

Supporting Documents

Please return copies of any media releases, documentation produced, news article reports, statistics or photographs in support of your initiative.  Evidence must be provided of recognition of the Shire’s contribution as outlines in the organisation’s application.

Please upload attachments below: 


I declare that the grant provided by the Shire has been spent in accordance with the purpose and conditions for which it was granted
I declare that the financial statements provided are a true and accurate record of the transactions for this project / event.
I certify that the information submitted is a true and accurate report.

Validate and Submit Form