Strengthening Medicare – General Practice (GP) Grants Program | Australian Government Department of Health and Aged Care

Financial Acquittal Report

Thank you for participating in the Strengthening Medicare - General Practice Grants Program.

As indicated in the funding agreement the grantee is required to submit a financial acquittal report to inform how the grant has been used and that the funding has been spent in accordance with the grant agreement.

Please complete this acquittal report as soon as practicable after the funding has been spent on eligible grant activities and no later than 31 July 2024.

Grant Details

Address of General Practice (mandatory)

Full legal name of Grantee (Practice name) (mandatory)

Trading as / Business name

Australian Business Number (ABN) (mandatory)

Please enter your ABN without any spaces between the numbers.

Primary Health Network (PHN) (mandatory)

General Practice email address (mandatory)

Agreement ID Number (mandatory)

The format for the Departmental Agreement ID is ABC1234567. If you do not know your Departmental Agreement ID, please use your PHN generated Agreement ID Number from your practice's grant agreement

Grant Funding

Total grant amount received as per the Grant Agreement (GST Exclusive) (mandatory)

Please indicate how much of the grant was spent in each of the following investment streams (GST Excl)

Enhance digital health capability

Must be between $0 and the Total grant amount received.

Upgrade infection prevention and control arrangements

Must be between $0 and the Total grant amount received.

Maintain accreditation against RACGP Standards for General Practices

Must be between $0 and the Total grant amount received.

Achieve accreditation against RACGP Standards for General Practices

Must be between $0 and the Total grant amount received.

Grant amount remaining

Reason for unspent funds

Financial declaration

Declaration (mandatory)

I verify:

That I am authorised by the rules governing the above Grantee (Practice Name) to provide this statement in respect of the grant activity and that:

the grant amount referred to above was spent in accordance with the Terms and Conditions under which the grant was provided;
the activities for which the grant was provided were completed as described in the grant agreement; and
all records of financial transactions relating to the grant will be kept in accordance with Section 10 of the Grant Agreement.

Giving false or misleading information is a serious offence.

Name of person making the declaration (mandatory)

Position in Organisation (mandatory)

In line with the Privacy Act 1988, by acknowledging you consent to the collection of any personal information you have entered in this form by the Department of Health and Aged Care (the Department) and to the use and disclosure of this information by the Department and Primary Health Networks funded by the Department for program management and reporting purposes.