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TOTAL
0
0
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0
0
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0
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0
0
Yes /No
Project Title (or Acronym) Grant agreement n°
FS1 Financial Statement(to be completed by the coordinator for the whole project)
Coordinator's legal name
Contact Person Telephone
2- Declaration of eligible costs (in €)The costs declared should distinguish between direct and indirect costs excluding VAT
Period from dd/mm/yyyy to dd/mm/yyyy
Nature of the financial statement (tick the relevant option)
□ further pre-financing payment
□ Final payment
COST CATEGORY
Personnel (max. 30% of total eligible costs)
Travel and substistence costs
Advertising and promotion costs
– All other costs
Optical and digital costs
Other costs
– Audit fees
– Subcontracting costs
3- Declaration of income (in €)
Total direct costs
Indirect costs (max 7 % of the total direct costs)
Total costs (right click to update the field)
Total
Own ressources
– Applicant's Investment
Private Sources
Public Funding other than the Preparatory action
– Action's Revenues
4- Requested EU funding (in €)
Pre-financing payment
Further pre-financing payment requested (if applicable)
Final payment requested (if applicable)
Total EU contribution (only in the case of the final payment)
5- Declaration of interest generated by the pre-financing (in €)
(to be completed only by the coordinator)
Did the pre-financing (advance) you received by the Commission for this period yield interest?
Signatures of the PM and of the AFO + date (dd/mm/yyyy)
i. the above costs are related to the resources necessary for the work under the grant agreement
ii. such costs have been incurred and comply with the definition of eligible costs specified in the grant agreement
(Article II.14 of Part B - Financial Provisions)
iii. full supporting documentation to justify the costs hereby declared is available for audit by the Commission and
its authorised representatives or the Court of Auditors.
Beneficiary's certificate:
We certify that:
If yes, please indicate the amount.
Name of the Authorised legal representative of the coordinator (PM):
Name of the duly authorised financial officer of the coordinator (AFO):
Max 0
Max 0
Name of the bebeneficiary: Rate per Day or
Unit Price
Number of Days
or Units
in Euro
1 - Personnel Costs (limited to 30% of the total eligible costs)
(please specify Name & Job Title)
1.1. - Management Staff (Managers, Executives…)
(add row if necessary)
1.2. - Assistants, Secretaries, Temporary Staff
(add row if necessary)
1.3. - Miscellaneous Staff (e.g. IT, accountancy…)
(add row if necessary)
TOTAL Heading 1 0
2 - Travel and substistance costs
2.1 - Travel costs
(add row if necessary)
2.2 - Subsistence costs
(add row if necessary)
TOTAL Heading 2 0
3 - Advertising and promotion costs
3.1 - Publicity material
3.1.1 - Poster design and layout
3.1.2 - Poster printing
3.1.3 - Slides and stills
3.1.4 - TV spots
3.1.5 - Radio spots
3.1.6 - Advertising / publicity material (all kinds): design and layout
3.1.7 - Flyers
3.1.8 - Production trailer
3.1.9 - Inter-negative trailer
3.1.10 - Prints of trailer
3.1.11 - Showreels and promoreels
3.1.12 - Poster costs
3.1.13 - Stills
3.1.14 - Advertising all kinds: design and layout
3.1.15 - Other (please specify below)
(add row if necessary)
3.2 - Publicity space
3.2.1 - Placing of publ. material (posters, trailers, flyers, mailing...)
3.2.2 - Advertising on TV
3.2.3 - Advertising on Radio
3.2.4 - Advertising on Internet
3.2.5 - Advertising in professional press
3.2.6 - Advertising in papers
3.2.7 - Advertising in magazines
3.2.8 - Advertising space markets and festivals
3.2.9 - Other (please specify below)
(add row if necessary)
3.3 - Promotion material and events
3.3.1 - Promotion material (press files, EPK, Beta,...)
3.3.2 - Market and Press screenings
Personnel costs, travel & subsistence costs & any budget item of more than € 10.000 should be broken down in detail
FS2 Financial StatementTo be completed by each beneficiary (coordinator + co-beneficiary(ies))
3.3.3 - Previews, receptions
3.3.4 - Test screenings and market research
3.3.5 - Promotional tour by director/cast
3.3.6 - Press Agency, Press Officer, Publicist, PR fees
3.3.7 - Website of film
3.3.8 - Other (please specify below)
(add row if necessary)
TOTAL Heading 3 0
4 - Optical and digital costs
4.1 - Prints
4.1.1 - Inter-negative optical trailer
4.1.2 - Inter-negative optical film
4.1.3 - Striking optical prints of trailers / number of prints
4.1.4 - Striking optical prints of film / number of prints
4.1.5 - Master digital trailer
4.1.6 - Master digital film
4.1.7 - Duplication digital copies of trailers / number of copies
4.1.8 - Duplication digital copies of films / number of copies
4.1.9 - Dubbing and Subttling (incl. Translation)
4.1.10 - Maintenance
4.1.11 - Transport and taxes levied on film
4.1.12 - Insurance
4.1.13 - Digital "Virtual" Print Fees
4.1.14 - Other (please specify below)
(add row if necessary)
TOTAL Heading 4 0
5 - Other costs
5.1 - Audit fees (cost of the certification by the Approved External Auditor of
the final report)
5.2 - Subcontracting costs (please specify below)
5.3 - All other costs (please specify below)
Other (please specify below)
(add row if necessary)
TOTAL Heading 5 0
SUB-TOTAL (1+2+3+4+5) 0
maximum
Overheads: May not exceed 7% of the total eligible costs (Sub-total)
0
TOTAL in Euro 0
% of total costs Currency Exchange
rate
ISO Code EUR=Personnel costs, travel & subsistence costs & any budget item of more than € 10.000 should be broken down in detail
FS2 Financial StatementTo be completed by each beneficiary (coordinator + co-beneficiary(ies))
How many prints
How many prints
How many copies
How many copies
1
2
add rows if
necessary
0
0
0
0
0
0
0
0
0
0
0Total EU contribution, only in the case of the final payment request
PART I
Total EU pre-financing payment
Total EU final payment requested, if applicable
Total EU first pre-financing payment
Total EU further pre-financing payment, if applicable
Total EU contribution, only
in the case of the final payment
request
PART II
Beneficiary
n°
Beneficiary
name
Public funding other than the Preparatory action
Total income
Total eligible costs
Applicant's Investment
Action revenues
Private sources
Total eligible
costs
EU pre-financing
payment
FS3 Consolidated Financial Statementto be completed by the coordinator for the whole project
EU further pre-financing
payment requested, if applicable
EU final payment
requested, if applicable
Part I
Date Date
Total (€)
Part II
Beneficiary Name Date Date
add rows if necessary
Total (€)
Part III
EU contribution not yet
distributed between
beneficiaries
FS4 Report on the breakdown of the EU contribution
Grant agreement n°
Project Title (or Acronym)
Amount Amount
EU contribution sent to the coordinator
Pre-financing paymentFurther pre-financing payment, if
applicable
0 0
Breakdown of EU contribution between beneficiaries
Pre-financing paymentFurther pre-financing payment, if
applicable
Further pre-financing payment, if
applicable
Amount Amount
0 0
0 0
0 0
Signature Date (dd/mm/yyyy)
EU contribution sent to the coordinator not yet distributed between beneficiaries
Pre-financing payment
Name (Authorised legal representative of the coordinator)
0 0
I certify that the information set out in this(these) form(s) is accurate and correct and agreed by all beneficiaries
Total Amount
Date Amount
0 0
Total Amount
Date Amount
0 0
0 0
0 0
Total Amount
0
FS4 Report on the breakdown of the EU contribution
EU contribution sent to the coordinator
Final payment
Breakdown of EU contribution between beneficiaries
Final payment
Date (dd/mm/yyyy)
EU contribution sent to the coordinator not yet distributed between beneficiaries
Final payment
0
I certify that the information set out in this(these) form(s) is accurate and correct and agreed by all beneficiaries
LIST OF INVOICES¹ For unique actions please only indicate the finishing date.2 See 1. Financial Statement - (Annex III)
PLEASE USE A SEPARATE TABLE FOR EACH SECTION OF THE BUDGET (i.e. Heading 1-Personnel costs, Heading 2-Travel and substistence costs, Heading 3-Advertising and promotion costs, Heading 4-Optical and digital costs, Heading 5-Other costs), RELEVANT TO THE EXPENDITURE YOU DECLARE.
Name of organisation
responsible for the expense
Starting date
(dd.mm.yy)
Finishing date
(dd.mm.yy)
Personnel costs
Budget Section
Date of the action¹
PLEASE USE A SEPARATE TABLE FOR EACH SECTION OF THE BUDGET (i.e. Heading 1-Personnel costs, Heading 2-Travel and substistence costs, Heading 3-Advertising and promotion costs, Heading 4-Optical and digital costs, Heading 5-Other costs), RELEVANT TO THE EXPENDITURE YOU DECLARE.
Date of
issue
Supplier of either
goods or servicesPurpose of the action Invoice N°
PLEASE USE A SEPARATE TABLE FOR EACH SECTION OF THE BUDGET (i.e. Heading 1-Personnel costs, Heading 2-Travel and substistence costs, Heading 3-Advertising and promotion costs, Heading 4-Optical and digital costs, Heading 5-Other costs), RELEVANT TO THE EXPENDITURE YOU DECLARE.
EURO
exchange
rate²
Currency
(ISO code)NET amount
VAT (only if not able
to recover)
% National/€ NET amount
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in National currency Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL NET
0.00
0.00
TOTAL EXPENDITURE
(EURO)
PLEASE USE A SEPARATE TABLE FOR EACH SECTION OF THE BUDGET (i.e. Heading 1-Personnel costs, Heading 2-Travel and substistence costs, Heading 3-Advertising and promotion costs, Heading 4-Optical and digital costs, Heading 5-Other costs), RELEVANT TO THE EXPENDITURE YOU DECLARE.
PAID by a
co-
organiser/
partner
from the
EURO area
IF PAID…NOT YET
PAID
VAT (only if not able
to recover)
%(tick here if
appropriate)
Date of
payment
(dd.mm.yy)
(tick here if
appropriate)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL VAT
0.00
0.00
TOTAL EXPENDITURE
(EURO)
LIST OF INVOICES¹ For unique actions please only indicate the finishing date.2 See 1. Financial Statement - (Annex III)
Name of organisation
responsible for the expense
Starting date
(dd.mm.yy)
Finishing date
(dd.mm.yy)
Personnel costs
Budget Section
Date of the action¹
Date of
issue
Supplier of either
goods or servicesPurpose of the action Invoice N°
EURO
exchange
rate²
Currency
(ISO code)NET amount
VAT (only if not able
to recover)
% National/€ NET amount
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in National currency Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL NET
0.00
0.00
TOTAL EXPENDITURE
(EURO)
PAID by a
co-
organiser/
partner
from the
EURO area
IF PAID…NOT YET
PAID
VAT (only if not able
to recover)
%(tick here if
appropriate)
Date of
payment
(dd.mm.yy)
(tick here if
appropriate)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL VAT
0.00
0.00
TOTAL EXPENDITURE
(EURO)
LIST OF INVOICES¹ For unique actions please only indicate the finishing date.2 See 1. Financial Statement - (Annex III)
Name of organisation
responsible for the expense
Starting date
(dd.mm.yy)
Finishing date
(dd.mm.yy)
Personnel costs
Budget Section
Date of the action¹
Date of
issue
Supplier of either
goods or servicesPurpose of the action Invoice N°
EURO
exchange
rate²
Currency
(ISO code)NET amount
VAT (only if not able
to recover)
% National/€ NET amount
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in National currency Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL NET
0.00
0.00
TOTAL EXPENDITURE
(EURO)
PAID by a
co-
organiser/
partner
from the
EURO area
IF PAID…NOT YET
PAID
VAT (only if not able
to recover)
%(tick here if
appropriate)
Date of
payment
(dd.mm.yy)
(tick here if
appropriate)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL VAT
0.00
0.00
TOTAL EXPENDITURE
(EURO)
LIST OF INVOICES¹ For unique actions please only indicate the finishing date.2 See 1. Financial Statement - (Annex III)
Name of organisation
responsible for the expense
Starting date
(dd.mm.yy)
Finishing date
(dd.mm.yy)
Personnel costs
Budget Section
Date of the action¹
Date of
issue
Supplier of either
goods or servicesPurpose of the action Invoice N°
EURO
exchange
rate²
Currency
(ISO code)NET amount
VAT (only if not able
to recover)
% National/€ NET amount
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in National currency Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL NET
0.00
0.00
TOTAL EXPENDITURE
(EURO)
PAID by a
co-
organiser/
partner
from the
EURO area
IF PAID…NOT YET
PAID
VAT (only if not able
to recover)
%(tick here if
appropriate)
Date of
payment
(dd.mm.yy)
(tick here if
appropriate)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL VAT
0.00
0.00
TOTAL EXPENDITURE
(EURO)
LIST OF INVOICES¹ For unique actions please only indicate the finishing date.2 See 1. Financial Statement - (Annex III)
Name of organisation
responsible for the expense
Starting date
(dd.mm.yy)
Finishing date
(dd.mm.yy)
Personnel costs
Budget Section
Date of the action¹
Date of
issue
Supplier of either
goods or servicesPurpose of the action Invoice N°
EURO
exchange
rate²
Currency
(ISO code)NET amount
VAT (only if not able
to recover)
% National/€ NET amount
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in National currency Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL NET
0.00
0.00
TOTAL EXPENDITURE
(EURO)
PAID by a
co-
organiser/
partner
from the
EURO area
IF PAID…NOT YET
PAID
VAT (only if not able
to recover)
%(tick here if
appropriate)
Date of
payment
(dd.mm.yy)
(tick here if
appropriate)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL VAT
0.00
0.00
TOTAL EXPENDITURE
(EURO)
LIST OF INVOICES¹ For unique actions please only indicate the finishing date.2 See 1. Financial Statement - (Annex III)
Name of organisation
responsible for the expense
Starting date
(dd.mm.yy)
Finishing date
(dd.mm.yy)
Personnel costs
Budget Section
Date of the action¹
Date of
issue
Supplier of either
goods or servicesPurpose of the action Invoice N°
EURO
exchange
rate²
Currency
(ISO code)NET amount
VAT (only if not able
to recover)
% National/€ NET amount
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in National currency Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL NET
0.00
0.00
TOTAL EXPENDITURE
(EURO)
PAID by a
co-
organiser/
partner
from the
EURO area
IF PAID…NOT YET
PAID
VAT (only if not able
to recover)
%(tick here if
appropriate)
Date of
payment
(dd.mm.yy)
(tick here if
appropriate)
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Amount in EURO - €
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL VAT
0.00
0.00
TOTAL EXPENDITURE
(EURO)
Recommended