Required fields are marked with asterisks (*)

Cemetery Grant Program Application Form:

Requirements and Guidelines
It is important to read the Cemetery Grant Program Policy before completing and submitting your Cemetery Grant Program Application to the Township.

1. Name of Cemetery Group of Association:

2. Year of Application:

3. Is this the first year to request a Cemetery Grant?

Yes

If yes, please include all documentation requested in item number 12 below.

4. Cemetery Representative Name:

Phone Number:

Email:

5. Mailing Address for Cemetery Grant Payments:

6. Year cemetery established (optional):

7. Total Maintained Land Area: (Number of acres or lot size):

8. Is the cemetery registered with the Bereavement Authority of Ontario (BAO)? If yes, provide your BAO Registration Number:

9. A member of the Executive is required to attest to the following:

9.1 A current bank account is held specifically for use by the cemetery group or association:

Yes

9.2 Please provide the name of Financial Institution:

9.3 There are two signing authorities on the bank account that do not live in the same household:

Yes

9.5 All procurement was done to ensure best value for dollar spent:

Yes

Name & Position of Person Making Attestations:

Signature:

Clear

Date:

10.1 Identify what the unspent cemetery grant funds are being held for:

Funding Amount Requested:

11. Identify the proposed use of the cemetery grant requested:

12. If available, please provide the following attachments:
(a) Copy of bank statement dated December 31 or if account only recently opened, copy most recent statement;
(b) List of all members of the cemetery group or association, including positions;
(c) A copy of the minutes creating the association or other appropriate establishing documentation such as constitution by-law, etc.

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13. Executive:

President Name

President Signature

Clear

Date

Treasurer Name

Treasurer Signature

Clear

Date

Secretary Name

Secretary Signature

Clear

Date

Forms

Cemetery Grant Program Application Form: