New Zealand Gazette – 1993 – No. 120

Page 2339

✨ Grant Scheme Claim and Report Form



EXPERT ASSISTANCE GRANT SCHEME - CLAIM AND REPORT FORM

SECTION A - for completion by the nominated consultant

SECTION B - for completion by the claimant

SECTION A

This section is for completion by the consultant principally responsible for carrying out the approved project for the approved company.

  1. Name(s) of other consultant(s) involved in the project (if any):

Role(s) of other consultant(s) in the project:

  1. The project commenced on __ (date).

It was/is due to be completed on __ (date).

The project has run to/under/over budget.

Give reason(s) if over or under budget:

  1. Has the project been carried out in accordance with the Terms of Reference? YES/NO

If NO give details.

  1. My total fee for the project is $__.

I have received payment of this fee in full/part payment of $__ on __.

The payment I have received is in respect of days/hours of my time at a daily/an hourly rate of $; and days/hours of other consultant(s) time at daily/hourly rate(s) of $

Disbursements of $__ are included in the fee. These are in respect of:

  1. Do you have a financial interest in the project, in the business for which the project was carried out, or in a parent, associate or subsidiary of that business? YES/NO

If YES give details

6 I declare that:

  • I undertake to advise the Business Development Board if I refund whole or part of the fee;
  • I understand that if incorrect or misleading information has been provided this may result in the Business Development Board withholding payment of the grant; the information provided above is true and correct.

Signature: __

Name: __

Date: __



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✨ LLM interpretation of page content

🏭 Expert Assistance Grant Scheme Claim and Report Form (continued from previous page)

🏭 Trade, Customs & Industry
Grant claim, Consultant report, Business Development Board, Project details, Financial disclosure