<p>Designated Report Form</p><p>Please provide a report on the designated grant(s) your organization received from The Rhode Island Foundation. Reporting is required to ensure release of the next grant. Submit your completed report form by September 30 by emailing it to [email protected]. Email subject line must contain your organization name and associated grant number. If you are reporting on more than one grant, please submit a separate form for each grant number. Reports are shared internally, please do not copy nor email Foundation staff directly.</p><p>Grant number: Grant amount: </p><p>Fund name: </p><p>Organization name: </p><p>Organization email address: </p><p>Organization telephone number: </p><p>Name and title of person completing application: </p><p>Date report submitted: </p><p>1. How was this grant used? List the major activities that this grant supported.</p><p>2. Provide the number of people served and the grant’s impact on the community through the project/program.</p><p>The Rhode Island Foundation  One Union Station  Providence, RI 02903  www.rifoundation.org</p><p>Revised 8/2013 1 3. Itemize expenses for which the grant was applied (budget form provided on following page).</p><p>EXPENSES (list below) BUDGET ACTUAL DIFFERENCE</p><p>Total Expenses </p><p>OTHER SUPPORT (list below) BUDGET ACTUAL DIFFERENCE</p><p>Total Other Support </p><p>4. If there are funds remaining, a conversation with the funds administrator may be required. Accounting is necessary to ensure all funds are expended according to the provisions and purpose of the fund. What is the amount remaining, and what is your plan for these funds?</p><p>5. Please provide current contact information for your organization:  Head of organization:  Title: </p><p> Organization: </p><p>The Rhode Island Foundation  One Union Station  Providence, RI 02903  www.rifoundation.org</p><p>Revised 8/2013 2  Street address: </p><p> City, state, zip: </p><p> Telephone: </p><p> Email: </p><p> Website: </p><p>The Rhode Island Foundation  One Union Station  Providence, RI 02903  www.rifoundation.org</p><p>Revised 8/2013 3</p>