New York/New Jersey Area Common Report Form - New Jersey

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Report Form
New York/New Jersey Area
Common Report Form
The purpose of the Common Report Form (CRF) is to help nonprofit organizations in the New
York/New Jersey area to save time in grant reporting. The CRF follows closely the format of
the New York/New Jersey Area Common Application Form. If several funders have given your
organization support for a particular project, only minor changes in the report information will
need to be made for each funder. Please note the following important points:
Every funder has different report deadlines and timetables.
The list of funders who will accept reports in this format continues to grow. If a
funder is not on the list, call to 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 their 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.
Philanthropy New York • 79 Fifth Avenue, Fourth Floor • New York, NY 10003-3076
212-714-0699 • www.philanthropynewyork.org
The Council of New Jersey Grantmakers • 101 West State Street • Trenton, NJ 08608 • 609-341-2022 • www.cnjg.org
Report Form
New York/New Jersey Area
Common Report Form
The purpose of the Common Report Form (CRF) is to help nonprofit organizations in the New
York/New Jersey area to save time in grant reporting. The CRF follows closely the format of
the New York/New Jersey Area Common Application Form. If several funders have given your
organization support for a particular project, only minor changes in the report information will
need to be made for each funder. Please note the following important points:
Every funder has different report deadlines and timetables.
The list of funders who will accept reports in this format continues to grow. If a
funder is not on the list, call to 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 their 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.
Philanthropy New York • 79 Fifth Avenue, Fourth Floor • New York, NY 10003-3076
212-714-0699 • www.philanthropynewyork.org
The Council of New Jersey Grantmakers • 101 West State Street • Trenton, NJ 08608 • 609-341-2022 • www.cnjg.org
Report Form
New York/New Jersey Area
Common Report Form Cover Sheet
Funder receiving report: _______________________________________________
Name of organization completing report. Please list exact legal name.
___________________________________________________________________
Address of organization: ________________________________________________
___________________________________________________________________
Telephone number: ____________________________________________________
Fax number: _________________E-mail address: _____________________________
Executive director: ____________________________________________________
Contact person and title (if not executive director): ____________________________
Have there been any changes to your organization’s IRS 501 (c)(3) not-for-profit status
since your request for this grant? (yes or no):________________
If yes, please explain: ___________________________________________________________
___________________________________________________________________________
Project name or brief project description:_____________________________________________
____________________________________________________________________________
Check one: General operating_____ Project support_____ Other (please specify)_______________
Grant amount: $__________________Grant Period: from______________to_______________
Date of report: _______________________ Report due date: ___________________________
Dates covered by this report: from_____________________to___________________________
Check one: This is an interim report_____ This is a final report______
Philanthropy New York • 79 Fifth Avenue, Fourth Floor • New York, NY 10003-3076
212-714-0699 • www.philanthropynewyork.org
The Council of New Jersey Grantmakers • 101 West State Street • Trenton, NJ 08608 • 609-341-2022 • www.cnjg.org
Report Form
New York/New Jersey Area
Common Report Form
Report Format
I. NARRATIVE---Two to five pages.
A.
If reporting for a general operating grant, please address the following:
Organizational and/or programmatic achievements and setbacks; significant
board and/or staff changes.
How you measured the effectiveness of your activities; what you learned; and
how you used or will use this information.
B.
If reporting on a specific project grant, please address the following:
The project description and how the project relates to your organization's
mission.
The project's goals and the success you had in meeting them. Have the
project’s goals been modified in any way? Describe the population served and
how that population was affected by the project. How were other stakeholders
affected? Any problems your organization faced when implementing this project,
and how you resolved or attempted to resolve them.
How you measured the effectiveness of your project; what you learned; and
how you used or will use this information. Were there any unexpected results,
positive or negative?
Any changes in the original staffing pattern for the project.
Any significant changes in your organization while implementing this project.
Philanthropy New York • 79 Fifth Avenue, Fourth Floor • New York, NY 10003-3076
212-714-0699 • www.philanthropynewyork.org
The Council of New Jersey Grantmakers • 101 West State Street • Trenton, NJ 08608 • 609-341-2022 • www.cnjg.org
Report Form
II.
FINANCIAL
A.
If reporting on a general operating grant, please submit the following:
Your organization's statement of income and expenditures for the year in
which the grant was used.
B.
If reporting on a specific project, please submit the following:
Your organization's statement of income and expenditures for the year in which the
grant was used.
For final reports, please provide project income and expenditure information
compared to the approved project budget. If there are any major discrepancies,
please explain.
For interim reports, please provide project income and expenditures-to-date
compared to the approved project budget. If there are any major discrepancies,
please explain.
A list of all sources of income for the project with amounts.
C.
Financial Attachments:
Most recent audited financial statements, if not already provided.
Most recent annual report, if not already provided.
III. ATTACHMENTS (optional)
Publications, educational materials, news articles, videotapes, or other relevant
materials about your organization or the funded project.
Philanthropy New York • 79 Fifth Avenue, Fourth Floor • New York, NY 10003-3076
212-714-0699 • www.philanthropynewyork.org
The Council of New Jersey Grantmakers • 101 West State Street • Trenton, NJ 08608 • 609-341-2022 • www.cnjg.org

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