Non-cash/In-kind costs certification form (Atlantic Fisheries Fund)
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Non-cash/In-kind costs certification
Recipient name: _________________________ Project number: _________________________
You must complete this form if you have received or provided an eligible non-cash or in-kind contribution for the project during the claim period.
The Recipient hereby certifies that they have received or included the following goods and/or services as a non-cash contribution in-kind in the implementation of the Atlantic Fisheries Fund project noted above.
| Date of donation | Description of services donated or goods provided | Calculation of the value of the services or goods provided | Quantity | Fair value of services or goods |
|---|---|---|---|---|
| Total | ||||
I hereby solemnly declare that the above information is true, knowing that this declaration is of the same force and effect as if made under oath and by virtue of the Canada Evidence Act. Furthermore, I certify that I have included the documents supporting the fair market value of the non-cash costs and can demonstrate evidence of the transfer of ownership or the receipt of services.
Recipient or person authorized to sign on behalf of the recipient
Signature: _________________________ Date: _________________________
Print name and title: _____________________________________________________
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