Annex d the Sir Robert Ho Tung Charitable Fund



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Annex D

The Sir Robert Ho Tung Charitable Fund

Application FOR ALLOCATION





Note:

  • Completed application form shall be submitted to relevant Government Bureaux/ Departments for nomination.

  • Financial figures shall be rounded off to the nearest 100.

  • Quotations shall be provided for the budget, if available.

  • Application forms without indication of the nominating Government Department's (or Bureau's) level of support will not be considered.

  • Results of the allocation, including the names of all or some recipient organisations and the amount of allocations, will be announced in press release and local newspapers.

To be used by LWB




Allocation Exercise


2017

Reference No.





Item Code





Amount allocated








Name of Agency

Cheque payable to

(if different from the name of agency)

Application Submitted via

Govt. Dept.

Govt. Bureau

In English (must be completed)












In Chinese (must be completed)



Address of Agency

Responsible Officer







Applicant

Govt. Dept.

Govt. Bureau

Name












Tel. No.













Fax No.













Title of application





Objective

& Description








Budget
(Set out on a separate sheet if necessary)


Breakdown of Items

Amount (HK$)

Supported Amount (HK$)

(to be completed by the nominating Department)









Total =







Schedule of implementation

Alternative sources

of funding

Consequence of this application not being approved

Start Date

End Date


















Recurrent Implications








Annual

Recurrent Cost

Source of Funds




















Departmental assessment of the applicant

(To be completed by the nominating Government Department)

The applicant is :

The applicant’s sources of funding:

(Please tick as appropriate)
a Government-subvented organisation

a member agency of the Community Chest

a registered charitable organisation under

section 88 of the Inland Revenue Ordinance





Track record of completing past projects

Other relevant information

(Please tick as appropriate)
outstanding

good

poor

N/A









Departmental assessment of the application

(To be completed by the nominating Government Department)

Comments

Level of support

Priority No.1

(only for applications ranked A & B)







  • A – High

  • B – Medium

  • C – Low

  • D – Not supported








FSTB’s comments on the application

(To be completed by the nominating Government Department

if the application has possible recurrent financial implications for the Government)





Bureau’s assessment of the application

(To be completed by the nominating Government Bureau

if the application costs HK$250,000 or over)

Comments

Level of support

Priority No. (only for applications ranked A & B)


A - High



  • B – Medium

  • C – Low

  • D – Not supported










1 All project applications nominated by the same bureau/ department should be consolidated and prioritised on one list.


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