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Application Form Sample

The document outlines the Commonwealth Financial Counselling (CFC) and Financial Capability (FC) services aimed at providing free, confidential support to individuals facing financial difficulties. It details the objectives and intended outcomes of a grant opportunity to enhance financial resilience and capability among individuals and communities. Additionally, it provides guidance on the application process, eligibility requirements, and necessary documentation for applicants seeking funding.

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0% found this document useful (0 votes)
4 views18 pages

Application Form Sample

The document outlines the Commonwealth Financial Counselling (CFC) and Financial Capability (FC) services aimed at providing free, confidential support to individuals facing financial difficulties. It details the objectives and intended outcomes of a grant opportunity to enhance financial resilience and capability among individuals and communities. Additionally, it provides guidance on the application process, eligibility requirements, and necessary documentation for applicants seeking funding.

Uploaded by

ashleyknight47
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
Download as pdf or txt
Download as pdf or txt
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OFFICIAL

Financial Wellbeing and Capability


Activity - Commonwealth Financial
Counselling and Financial Capability
Submission Reference:

Application Information

Commonwealth Financial Counselling (CFC)

CFC services provide access to free, confidential and non-judgmental information, advice and advocacy to
eligible people experiencing financial difficulty.

Financial Capability (FC)

FC services help people to build financial skills, knowledge and capabilities. Services should be tailored to
the needs of individuals, families and communities within the organisation's service area(s), including cultural,
geographic and other specific needs. Services should focus on early intervention and prevention to engage
people at an earlier point when signs of a financial crisis might be emerging, empowering individuals to make
informed financial decisions and feel confident about managing their money, in a safe, inclusive and non-
judgmental environment.

The objectives of this grant opportunity are:

• To provide safe, inclusive, culturally appropriate, timely and accessible financial counselling and
financial capability services to support people experiencing financial stress.
• To provide services that support the longer-term financial capability needs and build the confidence
and financial resilience of individuals, families and communities.

The intended outcomes of this grant opportunity are:

• Individuals, families and communities know where to go and how to access support if they are
experiencing financial difficulties or would like to build their financial capability skills.
• Individuals feel increased confidence to manage their money and are empowered to make informed
financial decisions.

Grant Round Administration

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This grant round is being administered by the Community Grants Hub, on behalf of the Department of
Social Services.

Closing Date/Time
Please refer to the Closing Date/Time in the Grant Opportunity Guidelines

Making Sure Your Application is Saved


Upon exiting the form please ensure that you use the ‘Save and Close’ button. The ‘Continue’ button
should only be used as you intend to progress through the form. For your Application to be saved when
exiting, you will need to click on:

• 'Save and Close', and


• 'Confirm'.

You will know that your application is saved when you are taken from the current application form page to
the ‘Form Saved’ page.

Note that the ‘Save and Close’ button will ask you to ‘Confirm’ that you wish to save the Application, which
you must do to complete the save process. If this is not done, your Application will not be saved.

You can return to your Application with the data saved using the link on the 'Form Saved' page that says
'Click here to return to your form' and confirming your submission reference ID details. Optionally, you can
access the saved form via the form open email received upon beginning the Application.

Grant Opportunity Documents


Read all information in the Grant Opportunity Documents before completing this Application Form. The
Grant Opportunity Documents are available on the GrantConnect website. Applications will be assessed
using the process outlined in the Grant Opportunity Guidelines.

Note: Applicants will be notified of the grant funding outcome on completion of the assessment process.

Application Help
Information about the Application process is available on the GrantConnect and Community Grants Hub
websites.

Applicants may direct any general enquiries, question relating to the Program, the Application process, and
requests for technical help or support by contacting:

• Phone 1800020283
• Email to support@communitygrants.gov.au

Please note applicants may submit questions relating to the Program or Application Process up until five
Business Days prior to the Closing Time and Date. A response will be provided within five business days.

Attachment Limits
This Application Form allows users to attach files to support their application. You must provide an
attachment where mandatory. Use the 'Upload File' button to select your file.

Accepted file types: .bmp, .doc, .docx, .gif, .jpeg, .jpg, .msg, .pdf, .png, .pps, .ppt, .pptx, .txt, .xls, .xlsb,
.xlsx.

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Note: There is a 2mb limit per attachment. Multiple documents should be scanned into a single document.
Compressed or zip files are not accepted. File names must be unique using English language/characters
and MUST not include foreign characters.

Sharing this Form


More than one person should not access this form at the same time as there is risk of information being lost
upon submission. Please ensure that only one user edits the form at any given time.

Submitting an application form


Upon starting the Application a ‘Form Opened’ email will be sent to the primary contact, which will include a
link to the Application Form as well as a submission reference ID. This will enable the Applicant to access
the form at any point in time.

Please note the form will no longer be accessible after two months of inactivity.

Once you have completed this Application Form, you must submit it electronically by using the submission
section at the end of this form.

Following electronic submission and completion of this Application Form, a message with your Submission
Reference ID will appear on your screen. An email will be sent to the primary contact provided in the
Application Form. A function is also available on the submission page to allow you to send a receipt email
to the address of your choosing. Please save this email receipt for future reference and use it in all
correspondence about this Application.

Please note: there may be short, scheduled outages to systems as part of regular information technology
maintenance that may affect submission of this form. Notification of these outages will be on the website.

National Relay Service (NRS)


The Community Grants Hub uses the NRS to ensure our contact numbers are accessible to people who
are deaf or have a hearing or speech impairment. Please phone 1800555677 to access the NRS.

Australian Tax Office Reporting


The Department will need to report details of payments made to the Australian Taxation Office (ATO) as
part of the taxable reporting obligations for government entities.

In general terms, the types of payments to be reported to the ATO are:

• Payments made for grants to entities with an Australian Business Number (ABN)
• Payments made for services.

If you receive a payment from the Department that meets the ATO criteria, it will be reported to the ATO as
part of the Taxable payments annual report. Further information is available on the Australian Taxation
Office website.

Privacy
The Community Grants Hub uses an integrated Smartform service assisted by the Department of Industry,
Science and Resources on www.business.gov.au.

If you are providing information to access a non-Department of Industry, Science and Resources program,
that information will not be accessed by Department of Industry, Science and Resources employees. The
only exception to this is where Senior Analysts within the Department of Industry, Science and Resources
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require access to your information for the sole purpose of troubleshooting technical errors. Where this
occurs Senior Analysts will only access the data with permission and at the request of client agencies.

The Community Grants Hub will be able to access the Application as part of the form support services.

By submitting the Application you acknowledge that the information provided in the Application may be
shared with other Commonwealth and law enforcement agencies for the prevention and detection of fraud.

For more information about how the Department of Industry, Science and Resources’ Privacy Policy. The
Community Grants Hub Privacy Policy and WCaG Accessibility Information and the Department of Social
Services Privacy Policy should also be read and understood. The privacy statement in the relevant Grant
Opportunity Guidelines should also be read and understood.

Use of Information

Your Submission Reference is:

Please send yourself a link to this saved form by entering your email address below. This email will detail
your Submission Reference, the date and time this application process will close, and a link to access your
saved form.

If you have any questions relating to this Application phone 1800020283 or email
support@communitygrants.gov.au.

Your email address*

Confirm your email address*

Use of Information
The Community Grants Hub may use the information, other than personal information, provided in this
Application Form to assist it to:

• Comply with the Australian Government requirement to publish the details of all grant recipients on
the GrantConnect website
• Inform staff negotiating and establishing Grant Agreements of risks and issues that need to be
addressed in the Grant Agreement for that program
• Inform future assessments for Applications.

All information including personal information collected as part of this Application may be used by the
department or shared with other Commonwealth and law enforcement agencies for the purpose of
preventing and detecting fraud. This includes personal information of any third party provided in this
Application.

You can only apply if you agree to the use of the information you provide in this form for the purposes listed
above and that you have read and acknowledged the Hub Privacy Policy, the Privacy Statement, and all
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relevant material (including the Grant Opportunity Guidelines) as they relate to the collection and handling
of personal information.

☐ I agree*

Existing Grant Recipient

Is the Applicant an existing Grant Recipient through the Community


Grants Hub?
If you require assistance, please call 1800020283.

☐ Yes ☐ No

If Yes, provide the Organisation ID number as it appears on your Grant Agreement and then click
'Verify ID' to confirm the details are correct.
Tip: Copy and paste the Organisation ID number from the Grant Agreement to avoid errors.

Organisation ID*

Applicant Legal Name

Registered Business Name

Entity Type ABN State

Postcode

☐ GST Registered ☐ Charity

☐ For Profit ☐ Withholding Tax Exempt

Are updates required to the Applicant’s details? *


You must respond to this question.

Select ‘No’ if updates are not required to the Applicant’s details as currently held by the Community Grants
Hub.

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Select ‘Yes’ if updates are required to the Applicant’s details as currently held by the Community Grants
Hub. You will be required to contact your Funding Arrangement Manager to update your details.

☐ Yes ☐ No

Please contact your Funding Arrangement Manager to update your


details.
Check this box to confirm that you have contacted your Funding Arrangement Manager and your
organisation information is now current.

☐ I confirm that I have contacted my Funding Arrangement Manager and my organisation information is
current. *

Eligibility Requirement

What is the Applicant’s entity type? *


For a list of eligible entity types, refer to the Guidelines.

If you are unsure about the Applicant's entity type, please seek professional advice (e.g. from your lawyer
or accountant) or refer to the Community Grants Hub website for further information.

Please note if you are applying as a Trustee on behalf of a Trust you must select the Trustee's entity type.

You must respond to this question.

Choose the entity type that is relevant to the Applicant from the list.

Is the Applicant able to provide documentation to support the entity


type? *
If yes is selected you will be required to provide documentation to support the legal entity.

NOTE: There is a maximum of two attachments for this question if the response is Yes.

You must respond to this question.

☐ Yes ☐ No

Please provide your supporting documentation. *

Organisation Type *
Is the Applicant an Indigenous organisation?

If YES, please select one definition below that best describes how your organisation is structured.

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If NO, please select 'Non-Indigenous organisation'.

Definitions:

• Indigenous community-controlled organisation: an organisation that is, at least, 51% Indigenous


owned and controlled, incorporated and not for profit.
• Owned and operated Indigenous organisation: an organisation that is, at least, 51% Indigenous
owned and controlled.
• Other Indigenous organisation: an organisation that is, at least, 50% Indigenous owned OR
controlled.

For more information, please refer to the Grant Opportunity Guidelines.

You must respond to this question.

Please select the relevant option.

☐ Indigenous community-controlled organisation

☐ Owned and controlled Indigenous organisation

☐ Other Indigenous organisation

☐ Non-Indigenous organisation

National Redress Scheme *


Confirm your organisation (or your project partner organisation) is not included on the National
Redress Scheme's website on the list of 'Institutions that have not joined or signified their intent to
join the Scheme'.

The National Redress Scheme for Institutional Child Sexual Abuse Grant Connected Policy makes non-
government institutions named in applications to the Scheme, or in the Royal Commission into Institutional
Responses to Child Sexual Abuse, that do not join the Scheme ineligible for future Australian Government
grant funding.

To be eligible for this Grant Opportunity you must respond to this question.

☐ I confirm

Workplace Gender Equality *


Please confirm you are NOT an organisation, and if applicable, your project partner/s is/are NOT an
organisation, included on the Workplace Gender Equality Agency website on the non-compliant list.

To be eligible for this Grant Opportunity you must respond to this question.

☐ I confirm

Child Safety Statement and Declaration *


Can you confirm the relevant Child Safe measures will be in place before the proposed activity
commences?

Note: If your proposed activity involves direct contact with children or contact with children is an
expected part of the activity, you are confirming the following measures will be in place before your
activity commences:

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• Child related employees, contractors or volunteers delivering the activity are compliant with all
State, Territory and Commonwealth law relating to the employment or engagement of people who
work or volunteer with children, including mandatory reporting and Working With Children Checks.
• National Principles for Child Safe Organisations are implemented.
• All Child-Related Personnel implement the National Principles for Child Safe Organisations.
• A risk assessment has been undertaken to identify the level of responsibility for Children and the
level of risk of harm or abuse to Children and appropriate risk management strategies to manage
any identified risks have been put in to place.
• A training and compliance regime is in place to ensure that all Child-Related Personnel are aware
of, and comply with:
o the National Principles for Child Safe Organisations;
o the Grantee's risk management strategy;
o Relevant Legislation relating to requirements for working with Children, including Working
With Children Checks; and
o Relevant Legislation relating to mandatory reporting of suspected child abuse or neglect,
however described.
• Any subcontracting arrangement entered into by the Grantee imposes the same obligations set out
here on the subcontractor and also requires the subcontractor to include those obligations in any
secondary subcontracts.

If your proposed activity falls under this category, and you are unable to confirm that the above
Child Safe measures will be in place before the activity commences, you may be ineligible for
funding. The delegate makes the final determination on eligibility.

Note: If your proposed activity involves irregular or unplanned contact with children, you are
confirming the following measures are in place before your activity commences:

• Child related employees, contractors or volunteers are compliant with all State, Territory and
Commonwealth law relating to the employment or engagement of people who work or volunteer
with children, including mandatory reporting and Working With Children Checks however described;
and
• Any subcontracting arrangement entered into by the Grantee, for the purposes of this grant
opportunity, imposes the obligations above on the subcontractor and also requires the
subcontractor to include those obligations in any secondary subcontracts.

If your proposed activity falls under this category, and you are unable to confirm that the above
Child Safe measures will be in place before the activity commences, you may be ineligible for
funding. The delegate makes the final determination on eligibility.

You must respond to this question.

Please select the relevant option.

Level of contact with children

Confirmation

Governance
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Relevant Persons*
Has any senior official or person to be involved in delivering the Activity been involved in any of the
following events in the last 5 years?

You must tick at least one of the boxes below.

You may be contacted to provide more information and documentation in relation to these events.

☐ Governance Investigation of relevant person(s).


☐ Any business failure of relevant person(s) including business failure of entities in which they hold, or held
at the time of the event, a management or board position. Examples of a business failure include a Court
Ordered or a Creditors Voluntary Administration Liquidation, External Administration, or Receivership.
☐ Bankruptcies of relevant person(s).
☐ Bankruptcy proceedings, including part IX Debt Agreements or Part X Insolvency Agreements, against
relevant person(s).
☐ Litigation against relevant person(s) including judgement debts.
or
☐ None of the above apply and there is no adverse information on any relevant person associate with this
entity
First Name * Last Name*

Position *

Description *

Does the Applicant have the following documents? *


Note: You may be required to provide copies of the below documentation within 7 days upon request.

1. Documented organisational and financial policies and procedures. *

☐ Yes ☐ No

2. Business plan and/or strategic plan. *

☐ Yes ☐ No

3. Risk management plan. *

☐ Yes ☐ No

Project/Activity Details

Provide a short title of your Application for this Project/Activity. *

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This field accepts the characters of A to Z, 0 to 9, ( ) , . ' & - / \ @ $ %, other characters and formatting are not
accepted.

Provide a brief description of your project or the services to be


delivered and how it will contribute to the objectives outlined in the
Grant Opportunity Guidelines. *
Question Instructions:

• The response should be easy to understand and written in plain English. Try not to use technical
terms, acronyms, or lingo.
• Your response should be a stand-alone summary of your project, or explain how you will implement
the services detailed in the Grant Opportunity Guidelines.
• The description may be used as part of our application review, and may be copied or published for
reporting or grant agreement purposes.

In which service area/s is the Applicant proposing to deliver the


Project/Activity? *
Instructions:

• The Service Area Type field below indicates the service areas relevant to this grant opportunity.
• If applicable, choose the relevant state/territory to view the available service areas.
• Tick the applicable service area/s where you are proposing to deliver this Project/Activity.
• Untick the selected service area/s to remove selection.

IMPORTANT NOTE:

You may only select 40 service areas per form. If you wish to apply for more services areas, a separate
form/s will need to be completed.

Selected service area/s *

Outlet Locations *
Provide a list of the postcode(s) where your Financial Wellbeing Hub outlet(s) are proposed to be located
within each SA4 being applied for. Please ensure a comma is inserted between each postcode.

For example: 4216, 4220, 4214.

If you are unsure of postcodes for communities you will be providing services in, please check the Australia
Post - Find a postcode site.

If you are unable to provide the postcode of your Financial Wellbeing Hub outlet due to this not yet being
determined, please list 0000.

You must respond to this question.

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This field accepts the characters of A to Z, 0 to 9, ( ) , . ' & - / \ @ $ %, other characters and formatting are not
accepted.

Financials

Provide a breakdown of the requested grant funding for each


previously selected service area/s.*

2025-2026 (exc GST) *

2026-2027 (exc GST) *

2027-2028 (exc GST) *

2028-2029 (exc GST) *

2029-2030 (exc GST) *

Total funding

Approx. % of Total

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Summary

2025-2026 total

2026-2027 total

2027-2028 total

2028-2029 total

2029-2030 total

Total funding

Provide bank account details for receipt of grant payments should


the Application be successful.
You must respond to this question.

Bank account details for the receipt of payments:

• BSB Number: Enter the BSB number for the Applicant’s nominated bank account. Must be 6 digits
only. Do not enter spaces or other characters.
• Account Number: Enter the account number for the Applicant’s nominated bank account. Must be 2
to 9 digits only. Do not enter spaces or other characters.
• Account Name: Enter the account name for the Applicant’s nominated bank account. The account
name should be as it appears on the bank statement. 60 character limit. The character count
includes letters, numbers, spaces, paragraph marks, bullet points etc.

NOTE: This field accepts the characters of A to Z, 0 to 9, ( ) , . ' & - / \ @, all other characters and formatting are not
accepted.

BSB Number* Account number*

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Account Name*

You must attach verification documentation to verify bank account details. *


Bank verification must accompany all applications. The following information is required in order to verify
the bank account details provided.

Acceptable verification documentation is a recent bank statement, issued in the last 6 months, in a pdf file
type. The bank account must be in the name of the organisation applying for funding. The transaction
details and balances can be hidden but the BSB, Account Number and Account Name must be visible.

You may be contacted by the Community Grants Hub seeking additional information to support the
verification of your bank account details.

Assessment Criteria

Describe your organisation's capability to deliver the grant activity


in the nominated service areas *
Your response must include information about:

• your organisation's track record, management approach, including the proposed governance
structure for administering the program in the target area, for example, normal or proposed
operations (including outlet location(s), hours of operation, delivery mechanisms (face-to-
face/online) proximity to transport, size, outreach services),
• the relevant capabilities (experience, skills and qualifications) of staff who are directly and indirectly
delivering Commonwealth Financial Counselling and Financial Capability services,
• development and training you will be providing to staff to ensure they have the necessary skills,
qualifications and support to deliver services to people accessing your services,
• how you will participate in sector wide projects, such as the National Debt Helpline Appointment
Booking system or similar projects that contribute to the capacity and capability building of the
financial counselling sector.

You must respond to this question.


This field accepts the characters of A to Z, 0 to 9, ( ) , . ' & - / \ @ $ %, other characters and formatting are not
accepted.

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Explain how your organisation will deliver the grant activity to


people in financial crisis *
Your response must include information about how your organisation will:

• determine people's eligibility to receive Commonwealth Financial Counselling and Financial


Capability services (see client eligibility information under 2.1) and how these services meet
community needs and adapt as community needs change over time,
• assist people experiencing financial stress and/or hardship with timely, practical support to address
their financial problems and empower them to make informed financial decisions,
• support people to build financial capability and resilience skills through early intervention and
longer-term measures, and
• measure and report on the outcomes achieved.

You must respond to this question.


This field accepts the characters of A to Z, 0 to 9, ( ) , . ' & - / \ @ $ %, other characters and formatting are not
accepted.

Explain how your organisation will support financially vulnerable


people with complex needs *
Your response must include information about how your organisation will:

• maintain or develop strong collaborative relationships with local support services to ensure people
can access additional support for non-financial matters. Other services may include family
relationship services, employment services, refugee services, family and domestic violence
services, mental health and housing programs.
• provide effective referral pathways internally and/or with local support services to address
underlying causes of financial stress (e.g. mental health, housing, substance abuse, gambling
issues).
• how you will report on these referrals including outcomes achieved through these referrals.

You must respond to this question.


This field accepts the characters of A to Z, 0 to 9, ( ) , . ' & - / \ @ $ %, other characters and formatting are not
accepted.

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Applicant Contacts

Who is the Applicant's preferred authorised contact person for this


Application?
The person must have authority to act on behalf of the Applicant in relation to this Application.

Title *

First Name* Last Name*

Position* Position Title*

Telephone * Mobile*

Email address*

Provide an alternate authorised contact for this Application.


This person must also have authority to act on behalf of the Applicant in relation to this Application.

Title *

First Name* Last Name*

Position* Position Title*

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Telephone * Mobile*

Email address*

Declaration

Do you have any conflicts of interest that may occur related to or


from submitting this application? *
☐ Yes ☐ No

Describe any conflicts of interest that may occur from submitting this Application.

Please read and complete the following declaration.


This Declaration must be signed by an authorised representative of the Applicant (or, if this Application is a
joint/consortium Application, an authorised representative of the lead organisation). The authorised
representative should be a person who is legally empowered to enter into contracts and commitments on
behalf of the Applicant.

I declare that:

• The information contained in this form is true and correct.


• I have read, understood and agree to abide by the Grant Opportunity Guidelines.
• I have read, understood and agree to the Grant Terms and Conditions, should this Application be
successful.
• I agree to receive a Recipient Created Tax Invoice (RCTI) for this funding, should this Application be
successful.
• I have read, understood and agree to information provided in this Application as detailed in the Use
of Information.
• If and where any personal details of a third party are included, the third party has been made aware
of, and given their permission for those details to appear in this Application and for their personal
information to be shared as detailed in the Use of Information.
• I give consent to the Community Grants Hub to make public the details of the Applicant and the
funding received, should this Application be successful.

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• I consent to receive correspondence, legal notices, grant agreements and any subsequent letters of
variations to the agreement electronically. I understand and agree that my electronic
correspondences constitute a valid and legally binding method for interacting under the grant
agreement and the Electronic Transactions Act 1999 (Cth).

☐ I understand and agree to the declaration above. *

☐ I acknowledge that giving false or misleading information to the Community Grants Hub is a serious
offence under Section 137.1 of the Criminal Code Act 1995 (Cth). *

Full name of Authorised Officer* Position of Authorised Officer* Date

Program Feedback
How did you hear about the grant opportunity?*

Did you read the grant opportunity guidelines?*

We welcome any additional feedback on the guidelines.

Your response is limited to 750 characters including spaces and does not support formatting.

How satisfied were you with the process of applying for a grant?

We welcome any additional feedback on the application process.

Your response is limited to 750 characters including spaces and does not support formatting.

Please provide an estimate of the time taken to complete this Application Form, including:
• Actual time spent reading the guidelines, instructions and questions
• Time spent by all employees in collecting and providing the information
• Time spent completing all questions in the Application Form.

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Hours Minutes

A copy of the receipt will be sent to: (the email provided)

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