Appendix ANNEX V MODEL FINAL REPORT ON IMPLEMENTATION OF THE ANNUAL PROGRAMME

MEMBER STATE:

FUND:

RESPONSIBLE AUTHORITY:

YEAR COVERED:

Time table on the implementation of the programme

Update from the progress report on the description of the organisation of the selection of projects (at the level of the Responsible Authority/Delegated authority or associated bodies) and their results, if appropriate

The achievements in implementing the actions of the programme under the priorities chosen

Actions implementing priority 1

Actions implementing priority 2

Etc.

Aspects of the action presented when describing each action under point 1.3 to etc.

Purpose and scope of the action

Changes from the programme as approved by the Commission (if appropriate)

Monitoring activities undertaken during and after the implementation

Actual results

Assessment of the actual results in comparison to the targets and indicators set in the programme

The results of the technical assistance

Problems encountered and measures taken on the implementation of the programme

Procedures applied when the responsible authority implemented project(s) directly acting as an executing body (if appropriate)

Coherence and complementarity with other instruments

Confirmation that no substantial changes to the Management and control system have taken place since the last revision notified to the Commission on …

ASSESSMENT OF THE PROGRESS MADE IN IMPLEMENTING THE MULTI-ANNUAL PROGRAMME

Measures taken to make the multi-annual^f1 and annual programme public

Implementation of the visibility principle

Project eligible expenditure and income, compliance with the non-profit rule and project summary description.

I, the undersigned [name in capitals of the person in charge],

representing the responsible authority for the [name of the Fund]

• request payment of the following amount:

  Total amount requested to complement the pre-financing payment(s).
  EURf4	+

  [exact figure to two decimal places]

  OR

• declare for reimbursement the following amount:

  Total amount to be reimbursed after the clearing of the pre-financing payment(s).
  EURf5	—

  [exact figure to two decimal places]

This amount results from the balance between the total amount of pre-financing payment(s) received for this annual programme and the actual expenditure declared.

This request for payment is admissible because:

1. a))

   a final report on implementation of the annual programme has been submitted to the Commission or is attached;

2. b))

   a certified declaration of expenditure has been submitted or is attached;

3. c))

   an annual audit report, an opinion on the functioning of the management and control system and a declaration on the validity of the payment request prepared by the audit authority have been submitted or are attached;

4. d))

   any interest generated by the pre-financing payments has been posted to the annual programme, being regarded as national contribution and has been taken into account in the declaration of expenditure;

5. e))

   the annual programme has been implemented according to the principle of sound financial management and there is a reasonable assurance that the underlying transactions are legal and regular;

6. f))

   there is no reasoned opinion by the Commission in respect of an infringement under Article 226 of the Treaty, as regards the actions for which the expenditure is declared in the request.

Payment should be made by the Commission to: