Grant Report

This form should be completed as soon as funds are spent
OR no later than one (1) year from date of receipt of grant check.

The form will be automatically emailed to: grantreport@thebolgerfoundation.org

Date of Grant

YYYY

Grantee/legal name of organization

Address of organization

Street

City

State

Zip Code

Phone number

(###)

###

####

Type of report

Name of executive officer or other contact person

Grant amount paid

Year Approved

Year Paid

Restricted grant purpose

If this is not a final report, please state approximately when a final report may be expected

Please confirm

I confirm that a grant in the amount stated above was received by this organization. I further confirm that all grant funds have been spent in accordance with the terms of the grant. The following is a financial breakdown and brief narrative regarding the use of these funds, including a statement indicating what impact the grant had on this organization and/or the community.

Financial breakdown, brief narrative, and impact statement

Signature of authorized official

Title

Date

YYYY

Any questions? Please contact us via email: info@thebolgerfoundation.org.

Grant Report

This form should be completed as soon as funds are spentOR no later than one (1) year from date of receipt of grant check.

The Bolger Foundation79 Chestnut StRidgewood, NJ 07450Phone number:(201) 670-9270

This form should be completed as soon as funds are spent
OR no later than one (1) year from date of receipt of grant check.

The Bolger Foundation
79 Chestnut St
Ridgewood, NJ 07450

Phone number:
(201) 670-9270