Common Report Form - Connecticut Council For Philanthropy
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1
2for
Connecticut Council
Philanthropy
formerly Coordinating Council for Foundations
C
R
F
OMMON
EPORT
ORM
The purpose of the common report form is to help nonprofit organizations in Connecticut prepare
informative and complete grant reports in a format that is consistent and efficient. Please note the following
important points:
• Every funder has different report deadlines and timetables.
• Before submitting this format, confirm that the funder will accept it.
Any funder that has agreed to accept this report form may request additional information at any stage in
•
the reporting process.
INSTRUCTIONS
•
Please type and single-space all reports.
•
Please answer all of the questions in the order listed.
•
Please use headings as provided.
•
Please submit only one copy.
Funder submitted to:_____________________________________________
Date:
Check One:
Interim Report
Final Report
SECTION A
Name of organization:
Name of executive director:
Address:
Phone:
Fax:
Email:
Contact person:
Title:
SECTION B
Project/program name (if applicable):
Purpose of grant:
___________________________________________________________________________________________________________________________
Grant period:
/
to
/
Period covered by this report:
/
to
/
Grant amount:
q
General operating
q Project support
q Challenge grant
q Capital/endowment
Sworn as true to the best of my knowledge and belief, subject to the penalties of false statement.
Signature of executive director:
Date:
Typed or printed name and title:_________________________________________________________________
Notice is hereby given that false statements intentionally given herein are subject to section 53a-157b of the Connecticut General
Statutes governing the penalty for written statements not believed to be true that are intended to mislead a public servant in the
performance of his or her official duties.
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