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- Original (As adopted by EU)
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This is the original version as it was originally adopted in the EU.
This legislation may since have been updated - see the latest available (revised) version
MEMBER STATE:
FUND:
RESPONSIBLE AUTHORITY:
YEAR COVERED:
Progress report on the implementation of the annual programme | ||||||||||
Table 1 | ||||||||||
Financial report | ||||||||||
Member State: […] Annual programme concerned: […] Situation at: [day/month/year] Pre-financing payment(s) received from EC: [amount] | ||||||||||
a If applicable. | ||||||||||
b Where appropriate, specific measures defined in the legal basis such as emergency measures or resettled persons. | ||||||||||
(all figures in EUR) | Ref. priority | Ref. specific prioritya | Programmed MS | Committed at the level of the MS | EC contribution paid by MS to final beneficiaries | Total eligible costs incurred to date by final beneficiaries | ||||
---|---|---|---|---|---|---|---|---|---|---|
Total programmed costs(a) | EC Contribution(b) | % EC(c = b/a) | Total eligible costs(d) | EC Contribution(e) | % EC(f = e/d) | |||||
Action 1: […] | ||||||||||
Action 2: […] | ||||||||||
Action 3: […] | ||||||||||
Action 4: […] | ||||||||||
Action 5: […] | ||||||||||
Action N: […] | ||||||||||
Technical assistance | ||||||||||
Other operationsb | ||||||||||
TOTAL | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
↓ | ↓ | |||||||||
> 60 % of pre-financing payment(s) received? | ||||||||||
Yes/No | Yes/No |
a Since the last progress/final report sent to the Commission. | ||
Notification of new irregularitiesa? | No | Yes (if Yes, fill in table 2) |
Table 2
Initial reporting on irregularity
Member State: […] | ||||||||
Situation at: [day/month/year] | ||||||||
Fund: […] | ||||||||
Reference | Annual programme | Project | Provision infringed | Type of irregularity | Date/source of first information | Method of detection | Possibility of fraud(Y/N) | Amount concerned in EUR(Community contribution) |
---|---|---|---|---|---|---|---|---|
Follow-up of previous irregularities? | No | Yes (if Yes, fill in table 3) |
Table 3
Reporting of follow-up of irregularities
Member State: […] | ||||||||||
Situation at: [day/month/year] | ||||||||||
Fund: […] | ||||||||||
Reference | Annual programme | Project | Provision infringed | Amount concerned(EC contrib. in EUR) | Follow-up actions | Recovery order(amounts in EUR) | Cancellation of EC contrib. | |||
---|---|---|---|---|---|---|---|---|---|---|
Issued | Paid | Default interest | Waived | |||||||
I, the undersigned [name in capitals of the person in charge],
representing the responsible authority for managing and implementing the [name of the Fund] request payment of the following amount as the second pre-financing payment.
a Total amount requested to complement the first pre-financing. | |
[exact figure to two decimal places] | |
EURa |
This request for payment is admissible because:
a progress report on implementation of the annual programme has been submitted to the Commission or is attached;
a certified declaration of expenditure drawn up accounting for at least 60 % of the amount of the first pre-financing has been submitted or is attached;
the annual programme has been implemented according to the principle of sound financial management and there is a reasonable assurance that the underlying transactions are legal and regular;
there is no reasoned opinion by the Commission in respect of an infringement under Article 226 of the Treaty, as regards the actions for which the expenditure is declared in the request.
Payment should be made by the Commission to:
Authority responsible for receiving payments | |
Bank | |
Bank account No | |
Account holder (if not the same as the authority responsible for receiving payments) |
Date
Name in capital letters, stamp, position and signature of competent authority
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