Document 4.pdf

Ref. Ares(2021)7295365 - 26/11/2021
ANNEX VI- part II -Actual costs reporting (Multibeneficiary)
This Annex is to be filled by applicants for a grant for an action.
The information provided here shall be accurate and complete.
For the section ''Personnel costs'', in particular, applicants should specify the nature
of the unit applied (hourly, daily, weekly, monthly).
Indirect costs are not eligible in case the applicant already received an operating
grant from the Union Budget.
Applicants should be aware that the total amount specified in Table 2 "Total Expenditure'' has to be equal
to the total amount specified in Table 3 ''Total sources of financing''.

In addition to the requirements of Article I.4.3.b (for interim reporting) and I.4.4.b (for final reporting), please
provide for each beneficiary a detailed breakdown of costs/amounts  reconciled with the actually incurred and
declared costs in accordance with the structure of Annex VI.
A minimum of information such as period covered, staff name, employment contract type, number of hours,
monthly hourly rates, description of cost, invoice ref, supplier name, invoice date, amount etc…must be
provided depending the cost category.
Important discrepancies between budget and actual cost incurred must be explained in a note to the financial
reporting.
The Commission reserves the right to ask for further supporting documents and additional clarification if
needed.

LC-01727348
ANNEX VI -Part II - Financial statement ACTUALLY INCURRED COSTS OF THE ACTION OF THE CONSORTIUM
TABLE 1: Total estimated eligible costs of the action and EU contribution (As declared in Annex III to the signed GA)
Actually incurred costs for
I. REIMBURSEMENT OF ELIGIBLE COSTS
period ../../.. To ../../..
EU
contribu
Estimated
Estimated EU
Total
tion
eligible
Estimated eligible costs
Total estimated
contribution
incurred
reimbur
ACTUAL
calculated on the basis of (1)
eligible costs
reimbursing
eligible
sing
COSTS
Max EU
eligible costs
costs
Reimbur eligible
funding % as
sement
actual
per call (2)
rate**
costs
Number Unit value
of units
/ rate per
Total
/days
days
(EUR)
(EUR)
(EUR)
(EUR)
(EUR)
(EUR)
(EUR)
(e) = (a)
(d) =
(a)
(b)
(c)
or
(f)
(g)=(e)*(f)
(j)
(h)
(k)
(b)*(c)
(e)= (d)
A. DIRECT ELIGIBLE COSTS
or
1. <Insert cost category 1 (e.g.
personnel costs)>
1.1. < Insert cost subcategory 1.1. (e.g.
technical personnel)>
1.2. <Insert cost subcategory 1.2 (e.g.
administrative personnel)>
…
Sub-total for cost category 1
2. <Insert cost category 2>
2.1. < Insert cost subcategory 2.1 >
….
Sub-total for cost category 2
3. <Insert cost category 3>
3.1. < Insert cost subcategory 3.1 >
…..
Sub-total for cost category 3
Total direct eligible costs
B. INDIRECT ELIGIBLE COSTS
(Max 7 % of total direct costs (3))
TOTAL ESTIMATED ELIGIBLE
COSTS

TOTAL EU ESTIMATED
CONTRIBUTION
(1) Including where declared by the applicant in accordance with its usual cost accounting practices
(2) in accordance to section 11.1.1 of the call for proposals. (see also Art I.3.2 (a) of the Model grant agreement).
** as per Art I.3.2 (a) of the
Same % for all eligible cost categories but not higher than the max EU co-funding rate fixed for the funded action
Grant Agreement
(3) except direct costs of subcontracting and financial support to third parties -if relevant
TABLE 3
TABLE 2
Estimated sources of financing
Estimated expenditure of the action
of the action
Expenditure
Amount
Revenue
Amount
1. Total eligible costs and
Receipts
contributions
2. Other costs of the action
1. Requested EU grant
3. Estimated value of contributions in
2. Income generated by the
kind (= 6 of Table 3)
action
3. Financial contributions
TOTAL
from third parties earmarked
to the eligible costs
Other revenue
4. Financial contribution of
the beneficiary (own
resources)
5. Other financial
contributions from third
parties
6. Contributions in kind
TOTAL (= TOTAL of
Table 2)

ACTUALLY INCURRED COSTS OF THE ACTION FOR applicant N°1 [insert name of applicant]
TABLE 1: Total estimated eligible costs of the action and EU contribution (As declared in Annex III to the signed GA)
I. REIMBURSEMENT OF ELIGIBLE COSTS
Estimated
eligible
Estimated eligible costs
ACTUAL
calculated on the basis of (1)
COSTS
Number Unit value
of units
/ rate per
Total
/days
days
(EUR)
(EUR)
(EUR)
(d) =
(a)
(b)
(c)
(b)*(c)
A. DIRECT ELIGIBLE COSTS
1. <Insert cost category 1 (e.g.
personnel costs)>
1.1. < Insert cost subcategory 1.1. (e.g.
technical personnel)>
1.2. <Insert cost subcategory 1.2 (e.g.
administrative personnel)>
…
Sub-total for cost category 1
2. <Insert cost category 2>
2.1. < Insert cost subcategory 2.1 >
….
Sub-total for cost category 2
3. <Insert cost category 3>
3.1. < Insert cost subcategory 3.1 >
…..

Sub-total for cost category 3
Total direct eligible costs
B. INDIRECT ELIGIBLE COSTS
(Max 7 % of total direct costs(3))
TOTAL ESTIMATED ELIGIBLE
COSTS
TOTAL EU ESTIMATED
CONTRIBUTION
(1) Including where declared by the applicant in accordance with its usual cost accounting practices
(2) in accordance to section 11.1.1 of the call for proposals. (see also Art I.3.2 (a) of the Model grant agreement).
Same % for all eligible cost categories but not higher than the max EU co-funding rate fixed for the funded action
(3) except direct costs of subcontracting and financial support to third parties -if relevant
TABLE 3
TABLE 2
Estimated sources of financing
Estimated expenditure of the action
of the action
Expenditure
Amount
Revenue
1. Total eligible costs and
Receipts
contributions
2. Other costs of the action
1. Requested EU grant
3. Estimated value of contributions
2. Income generated by the
in kind (= 6 of Table 3)
action
3. Financial contributions
TOTAL
from third parties earmarked
to the eligible costs
Other revenue
4. Financial contribution of
the beneficiary (own
resources)
5. Other financial
contributions from third
parties
6. Contributions in kind
TOTAL (= TOTAL of
Table 2)

ACTUALLY INCURRED COSTS OF THE ACTION FOR applicant N°1 [insert name of applicant]
TABLE 1: Total estimated eligible costs of the action and EU contribution (As declared in Annex III to the signed GA)
Actually incurred costs for
I. REIMBURSEMENT OF ELIGIBLE COSTS
period ../../.. To ../../..
EU
contribu
Estimated EU
Total
tion
Total estimated
contribution
incurred
reimbur
eligible costs
reimbursing
eligible
sing
Max EU
eligible costs
costs
Reimbur eligible
funding %
sement
actual
as per call
rate**
costs
(2)
(EUR)
(EUR)
(EUR)
(EUR)
(e) = (a)
or
(f)
(g)=(e)*(f)
(j)
(h)
(k)
(e)= (d)

(1) Including where declared by the applicant in accordance with its usual cost accounting practices
(2) in accordance to section 11.1.1 of the call for proposals. (see also Art I.3.2 (a) of the Model grant agreement).
** as per Art I.3.2 (a) of the
Same % for all eligible cost categories but not higher than the max EU co-funding rate fixed for the funded action
Grant Agreement
(3) except direct costs of subcontracting and financial support to third parties -if relevant
TABLE 3
Estimated sources of financing
of the action
Revenue
Amount
Receipts
1. Requested EU grant
2. Income generated by the
action
3. Financial contributions
from third parties earmarked
to the eligible costs
Other revenue
4. Financial contribution of
the beneficiary (own
resources)
5. Other financial
contributions from third
parties
6. Contributions in kind
TOTAL (= TOTAL of
Table 2)

ACTUALLY INCURRED COSTS OF THE ACTION FOR applicant N°2 [insert name of applicant]
TABLE 1: Total estimated eligible costs of the action and EU contribution (As declared in Annex III to the signed GA)
Actually incurred costs for
I. REIMBURSEMENT OF ELIGIBLE COSTS
period ../../.. To ../../..
EU
contribu
Estimated
Estimated EU
Total
tion
eligible
Estimated eligible costs
Total estimated
contribution
incurred
reimbur
ACTUAL
calculated on the basis of (1)
eligible costs
reimbursing
eligible
sing
COSTS
Max EU
eligible costs
costs
Reimbur eligible
funding % as
sement
actual
per call (2)
rate**
costs
Number Unit value
of units
/ rate per
Total
/days
days
(EUR)
(EUR)
(EUR)
(EUR)
(EUR)
(EUR)
(EUR)
(e) = (a)
(d) =
(a)
(b)
(c)
or
(f)
(g)=(e)*(f)
(j)
(h)
(k)
(b)*(c)
(e)= (d)
A. DIRECT ELIGIBLE COSTS
1. <Insert cost category 1 (e.g.
personnel costs)>
1.1. < Insert cost subcategory 1.1. (e.g.
technical personnel)>
1.2. <Insert cost subcategory 1.2 (e.g.
administrative personnel)>
…
Sub-total for cost category 1
2. <Insert cost category 2>
2.1. < Insert cost subcategory 2.1 >
….
Sub-total for cost category 2
3. <Insert cost category 3>
3.1. < Insert cost subcategory 3.1 >
…..
Sub-total for cost category 3
Total direct eligible costs
B. INDIRECT ELIGIBLE COSTS
(Max 7 % of total direct costs(3))
TOTAL ESTIMATED ELIGIBLE
COSTS

ACTUALLY INCURRED COSTS OF THE ACTION FOR applicant N°3 [insert name of applicant]
TABLE 1: Total estimated eligible costs of the action and EU contribution (As declared in Annex III to the signed GA)
I. REIMBURSEMENT OF ELIGIBLE COSTS
Estimated
eligible
Estimated eligible costs
ACTUAL
calculated on the basis of (1)
COSTS
Number Unit value
of units
/ rate per
Total
/days
days
(EUR)
(EUR)
(EUR)
(d) =
(a)
(b)
(c)
(b)*(c)
A. DIRECT ELIGIBLE COSTS
1. <Insert cost category 1 (e.g.
personnel costs)>
1.1. < Insert cost subcategory 1.1. (e.g.
technical personnel)>
1.2. <Insert cost subcategory 1.2 (e.g.
administrative personnel)>
…
Sub-total for cost category 1
2. <Insert cost category 2>
2.1. < Insert cost subcategory 2.1 >
….
Sub-total for cost category 2
3. <Insert cost category 3>
3.1. < Insert cost subcategory 3.1 >
…..

ACTUALLY INCURRED COSTS OF THE ACTION FOR applicant N°3 [insert name of applicant]
TABLE 1: Total estimated eligible costs of the action and EU contribution (As declared in Annex III to the signed GA)
Actually incurred costs for
I. REIMBURSEMENT OF ELIGIBLE COSTS
period ../../.. To ../../..
EU
contribu
Estimated EU
Total
tion
Total estimated
contribution
incurred
reimbur
eligible costs
reimbursing
eligible
sing
Max EU
eligible costs
costs
Reimbur eligible
funding %
sement
actual
as per call
rate**
costs
(2)
(EUR)
(EUR)
(EUR)
(EUR)
(e) = (a)
or
(f)
(g)=(e)*(f)
(j)
(h)
(k)
(e)= (d)

ACTUALLY INCURRED COSTS OF THE ACTION FOR applicant N°4 [insert name of applicant]
TABLE 1: Total estimated eligible costs of the action and EU contribution
I. ESTIMATED ELIGIBLE COSTS
Estimated
eligible
Estimated eligible costs
ACTUAL
calculated on the basis of (1)
COSTS
Number Unit value
of units
/ rate per
Total
/days
days
(EUR)
(EUR)
(EUR)
(d) =
(a)
(b)
(c)
(b)*(c)
A. DIRECT ELIGIBLE COSTS
1. <Insert cost category 1 (e.g.
personnel costs)>
1.1. < Insert cost subcategory 1.1. (e.g.
technical personnel)>
1.2. <Insert cost subcategory 1.2 (e.g.
administrative personnel)>
…
Sub-total for cost category 1
2. <Insert cost category 2>
2.1. < Insert cost subcategory 2.1 >
….
Sub-total for cost category 2
3. <Insert cost category 3>
3.1. < Insert cost subcategory 3.1 >
…..

ACTUALLY INCURRED COSTS OF THE ACTION FOR applicant N°4 [insert name of applicant]
TABLE 1: Total estimated eligible costs of the action and EU contribution
Actually incurred costs for
I. ESTIMATED ELIGIBLE COSTS
period ../../.. To ../../..
EU
contribu
Estimated EU
Total
tion
Total estimated
contribution
incurred
reimbur
eligible costs
reimbursing
eligible
sing
Max EU
eligible costs
costs
Reimbur eligible
funding %
sement
actual
as per call
rate**
costs
(2)
(EUR)
(EUR)
(EUR)
(EUR)
(e) = (a)
or
(f)
(g)=(e)*(f)
(j)
(h)
(k)
(e)= (d)

In-kind contributions (1)
Number of
Total value €
Description of item
Unit value
units
(2)
TOTAL
(1) May not include volunteers' work
(2) Approximate value