PUBLICWELFAREFOUNDATIONFINALINTERIMREPORT.doc

Public Welfare Foundation INTERIM Report Grant # ____________ Date of Submission_______________ The Foundation requests from its grantees regular financial and narrative reports on grant work they have performed. For multi-year grants, interim reports are due 30 days after the end of each year of funding, with a final report due two months following the full grant period. Please contact us if your report will not be submitted by these deadlines. NOTE: Please do not use this form if you are submitting a progress report as part of a renewal request. Instead please use the “Final/Progress Report” template available on our website. Name of Organization: Grant Period: Time Period Covered by Interim Report: Name and Title of Person Completing the Report: Telephone: E-Mail: Total grant received from the Public Welfare Foundation: Total amount of UNEXPENDED funds as of the date of your report: (only for Program/Project Support Grants) Required Confirmation: I confirm that the information contained in this report is accurate and complete. Signature of Chief Executive Officer Or Other Authorized Signatory: ___________________________________________________________________ Printed Name: Title: Date of Signing: _________________________________________________________________________________ Please upload this document in your follow-up form on our online grant portal. The cover sheet must be signed by an authorized signatory. Narrative: In no more than five pages, please respond to the following questions for the year of funding on which you are reporting. You may use bulleted format as appropriate. Please note that the interim report is meant to be a brief summary of the grant activities and progress toward outcomes during the year on which you are reporting. A more comprehensive report on the entire grant period will be requested at the conclusion of the grant. Describe the activities you have conducted pursuant