Biodiversity Challenge Funds
                                                    GRANT CLAIM FORM
                      Actual Expenditure – IWT Challenge Fund, Darwin Initiative and Darwin Plus
                           This form covers both Final Claims and Q4 Actual claims for 2022-23
                           Please send one signed claim to Darwin Finance,  darwin-finance@ltsi.co.uk
                              Signatures should match those on the current signatory panel.
             Project Reference No:                                                FOR INTERNAL USE ONLY
             Grantee Organisation:                                         Received/checked date
             Organisation Address:                                         Accepted/checked date
                                                                           Reason for any significant difference above
             Project Title:                                                Submitted early/report delayed
                                                                           Clarification required/Other
             1. Claim period                                               PO number:        
                Quarter No                                                 Receipt number
                Expenditure from           (Month and year)                Claim total:         
                Expenditure to:            (Month and year)                Date to SSCL:  
                                                                           Invoice Reference:
               2. Claim Amount and Certification
             I claim £                from the Department for Environment, Food and Rural Affairs, being a payment for
             work funded by the IWT Challenge Fund/Darwin Initiative for the year beginning 01 April 2022. I certify that,
             to the best of my knowledge and belief, the information is accurate, the expenditure has been properly
             incurred and that no other grant has been or will be claimed from Central Government or government agency
             towards these costs without the full knowledge and agreement of the Department.
             I accept that the Department will retain a portion of the award as set out in the Finance guidance until the
             final report review is received to the Department’s satisfaction and that the retention may fall across two
             financial years, depending on the balance of funds available in the final year.
             Signed:                                                 Date:               
             To be completed by signatory authorised on the original Grant Acceptance Form or notified to the Department thereafter
               3. International payments (i.e. to a non-UK bank)
             Confirmation of bank details - please reconfirm your bank details and currency.  Any details that do 
             not match a previous claim will be checked and may delay payment.
             Name of organisation on bank account:        
             Bank Name:                                   
             Bank Account/IBAN Number:                    
             Bank Swift Code:                             
             Payments are normally in GBP but can be different.   Please confirm currency for payment:       
             Please include any additional routing information to support the transfer:
             Intermediary bank details:     
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                4.   Contact Details – Who should we contact if we have queries about the information on this claim form? 
              Name:                                                          Position              
              Telephone number:                                              E-mail:               
              Address:                         
                5.   Changes – Please tick the box below if the details have changed since your last grant payment.
                         Signatory panel           You must attach a new/amendment to signatory panel form1
                         Banking details           You must attach a new supplier set-up form1
                6.   Staff
              Please provide the actual total expenditure on employment of staff for the year, where funded under this 
              year’s grant
                        Staff employed              Date work commenced            Proportion of this time          Cost to
                 (Provide name and position)        and finished in 2022/23           spent on this work          IWT/Darwin
                                                                                                                        (£)
                                                                                                                                
                                                                                                                                
                                                                                                                                
                                                                                                                                
                                                                                                                                
                                                                                                                                
            TOTAL (must match Staff Costs total in Section 9)                                                                   
                7.   Capital items
              Please provide a description of all the capital items funded under this year’s grant (including costs and their 
              location)
                            Capital items – description                    Capital items - location        Capital items –
                                                                                                               cost (£)
                                                                                                                            
                                                                                                                            
                                                                                                                            
                                                                                                                            
                                                                                                                            
                                                                                                                            
                                                                                                                            
                                                                                                                            
                                                                                                                            
                TOTAL (Must match Capital items total in Section 9)                                                         
                1
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                8.   Others
              Please provide a description of the ‘other’ items funded under this year’s grant (including costs)
                                               Other items – description                                    Other items – cost
                                                                                                                     (£)
                                                                                                                               
                                                                                                                               
                                                                                                                               
                                                                                                                               
                                                                                                                               
                                                                                                                               
                TOTAL (Must match Others total in Section 9)                                                                   
                9.   Total IWT/Darwin Costs – please note that you should only include IWT/Darwin costs, not the 
                     total costs that may come from other sources
                 Current Year’s Costs              2022/23          2022/23         Variance      Comments (please explain any 
                                                    Grant        Total actual           %         variance )
                                                      (£)           Darwin
                                                                   Costs (£)
            Staff costs (from Section 6)                                                               
            Consultancy Costs                                                                          
            Overhead Costs                                                                             
            Travel and subsistence                                                                     
            Operating Costs                                                                            
            Capital items (from Section 7)                                                             
            Others (from Section 8)                                                                    
            Audit costs                                                                                
                                                                                                                                 
                                                                                  Claimed So       Claim for        Surrender/ 
                                                                                  Far              this period      Overclaim 
            TOTAL                                                                                                                     
                                                           A                 B                  C..              D..                   E..
                A This should match the total annual grant approved in the offer letter or agreed with the Department 
                     through a subsequent Change Request
                B    This should be the actual costs incurred (the sum of the figures above)
                C    Amount already claimed for this financial year
                D    Either A or B (whichever is the lesser amount) minus C. This is the figure that should appear in 
                     Section 2 as the amount you are claiming
                E    Any balance of funds will be assumed surrendered to Defra.  Please confirm below if your balance is
                     more than £5,000.  If you have Overclaimed, and have funds in hand at the end of the year (ie B is 
                     less than C above) these funds will be offset against your claims for the next financial year.     
                 I confirm that any balance of funds is surrendered back to Defra                          Yes / No
                 Only exceptional Change Requests can be considered for 2021/22 and must be 
                 submitted as a matter of urgency. 
               These forms are available at https://www.darwininitiative.org.uk/resources-for-projects/claim-forms-and-finance-
              guidance/, https://iwt.challengefund.org.uk/resources/claim-forms-and-finance-guidance/, 
              https://dplus.darwininitiative.org.uk/resources/claim-forms-and-finance-guidance/
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