Dies ist eine HTML Version eines Anhanges der Informationsfreiheitsanfrage 'FP6 & FP7 legal basis of certain contractual provisions, protection of personal data'.


Ref. Ares(2012)1389824 - 23/11/2012
FP7 - Grant Agreement - Annex VI - Collaborative Project
Summary Financial Report - Collaborative Project
Reporting 
Project acronym
xxxxxxxxxxxxxxxxxxxxxxxxx
Project nr
nnnnnn
dd/mm/aa
to: 
dd/mm/aa
Page
1/1
period from
Funding scheme
CP
Type of activity
Total 
Demonstration
Management 
(A)+(B)+(C)+(D)
RTD          (A)
Other  (D)
Beneficiar If 3rd Party, linked  Adjustment
Organisation
(B)
(C)
y n°
to beneficary
(Yes/No)
 Short Name
Max EC 
Max EC 
Max EC 
Max EC 
Total Max 
EC 
Total
Total
Total
Total
Receipts
Interests
Contribution
Contribution
Contribution
Contribution
Contribution
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL
Requested EC contribution for the reporting period (in  €)

FP7 - Grant Agreement - Annex VI - Collaborative Project
Form C -  Model of Financial Statement (to be filled in by each beneficiary )
Project nr
nnnnnn
Funding scheme
Collaborative Project
Project Acronym
xxxxxxxxxxxxxxxxxxxxx
Period from 
dd/mm/aa
Is this an adjustment to a previous statement ?  
Yes/No
To 
dd/mm/aa
Legal Name
Organisation short Name
Beneficiary nr
nn
Funding % for RTD activities (A)
If flat rate for indirect costs, specify  %
%
1- Declaration of eligible costs/lump sum/flate-rate/scale of unit (in  €)
Type of Activity
RTD
Demonstration
Management 
Other 
TOTAL             
(A)
(B)
(C)
(D)
(A+B+C+D)
Personnel costs
Subcontracting
Other direct costs
Indirect costs
Lump sums/flat-rate/scale of 
unit declared

Total 
Maximum EC contribution
Requested EC contribution
2- Declaration of receipts
Did you receive any financial transfers or contributions in kind, free of charge from third parties or did the project generate 
Yes/No
any income which could be considered a receipt according to Art.II.17 of the grant agreement ?
If yes, please mention the amount (in €)
3- Declaration of interest yielded by the pre-financing  (t o be completed only by the coordinator  )
Did the pre-financing you received generate any interest according to Art. II.19 ?
Yes/No
If yes, please mention the amount (in €)
4. Certificate on the methodology
Do you declare  average personnel costs according to Art. II.14.1 ?
Yes/No
Is there a certificate on the methodology provided by an independent auditor and accepted by the Commission according to 
Yes/No
Art. II.4.4 ?
Cost of the certificate (in  €), if charged 
Name of the auditor
under this project
5- Certificate on the financial statements
Is there a certificate on the financial statements provided by an independent auditor attached to this financial statement 
Yes/No
according to Art.II.4.4 ?
Name of the auditor
Cost of the certificate (in  €)
6- Beneficiary’s Certificate
We certify  that:
- the costs declared above are directly related to the resources used to attain the objectives of the project and fall within the definition of eligible costs 
specified in Articles II.14 and II.15  of the grant agreement, and, if relevant,  Annex III and Article 9 (special clauses) of the 
grant agreement ;
- the receipts declared above are the only financial transfers or contributions in kind, free of charge, from third parties and the only income generated by 
the project which could be considered as receipts according to Art. II.17 of the grant agreement ;
- the interest declared above is the only interest  yielded by the pre-financing which falls within the definition of Art. II.19 of the 
grant agreement  ;
- there is full supporting documentation to justify the information hereby declared. It will be made available at the request of the 
Commission  and in the 
event of an audit by the Commission  and/or by the Court of Auditors and/or their authorised representatives.
Beneficiary’s Stamp
Name of the Person(s) Authorised to sign this Financial Statement
Date & signature


FP7 - Grant Agreement - Annex VI - Collaborative Project
Form C -  Model of Financial Statement (to be filled in by Third Party )   Only applicable if special clause nr 9 is used
Project nr
nnnnnn
Funding scheme
Collaborative Project
Project Acronym
xxxxxxxxxxxxxxxxxxxxx
Period from 
dd/mm/aa
Is this an adjustment to a previous statement ?  
Yes/No
To 
dd/mm/aa
3rd party legal Name
3rd party Organisation short Name
Working for beneficiary nr
nn
Funding % for RTD activities (A)
If flat rate for indirect costs, specify  %
%
1- Declaration of eligible costs/lump sum/flate-rate/scale of unit (in  €)
Type of Activity
RTD
Demonstration
Management 
Other 
TOTAL             
(A)
(B)
(C)
(D)
(A+B+C+D)
Personnel costs
Subcontracting
Other direct costs
Indirect costs
Lump sums/flat-rate/scale of 
unit declared

Total 
Maximum EC contribution
Requested EC contribution
2- Declaration of receipts
Did you receive any financial transfers or contributions in kind, free of charge from third parties or did the project generate 
Yes/No
any income which could be considered a receipt according to Art.II.17 of the grant agreement ?
If yes, please mention the amount (in €)
3- Declaration of interest yielded by the pre-financing  (t o be completed only by the coordinator  )
Did the pre-financing you received generate any interest according to Art. II.19 ?
Yes/No
If yes, please mention the amount (in €)
4. Certificate on the methodology
Do you declare  average personnel costs according to Art. II.14.1 ?
Yes/No
Is there a certificate on the methodology provided by an independent auditor and accepted by the Commission according to 
Yes/No
Art. II.4.4 ?
Cost of the certificate (in  €), if charged 
Name of the auditor
under this project
5- Certificate on the financial statements
Is there a certificate on the financial statements provided by an independent auditor attached to this financial statement 
Yes/No
according to Art.II.4.4 ?
Name of the auditor
Cost of the certificate (in  €)
6- Beneficiary’s Certificate
We certify  that:
- the costs declared above are directly related to the resources used to attain the objectives of the project and fall within the definition of eligible costs 
specified in Articles II.14 and II.15  of the grant agreement , and, if relevant,  Annex III and Article 9 (special clauses) of the grant agreement ;
- the receipts declared above are the only financial transfers or contributions in kind, free of charge, from third parties and the only income generated by 
the project which could be considered as receipts according to Art. II.17 of the grant agreement ;
- the interest declared above is the only interest  yielded by the pre-financing which falls within the definition of Art. II.19 of the 
grant agreement  ;
- there is full supporting documentation to justify the information hereby declared. It will be made available at the request of the 
Commission  and in the 
event of an audit by the Commission  and/or by the Court of Auditors and/or their authorised representatives.
Beneficiary’s Stamp
Name of the Person(s) Authorised to sign this Financial Statement
Date & signature


Document Outline