Worksheet: prepare to report to the ACNC
This is not the Annual Information Statement.
The ACNC will not accept this worksheet as submission of your
charity’s Annual Information Statement.
You can use this worksheet to prepare to submit your 2016 Annual Information Statement, prior
to completing it online. If you fill out this worksheet, you can share it with your charity’s board or
committee (governing body) for approval, if needed.
Note: It is not a requirement to use this worksheet. You can enter draft answers directly into the
Annual Information Statement in the Charity Portal, however you cannot print your answers until
the statement has been submitted.
Steps to use worksheet: prepare to report to the ACNC
1. Complete the Checklist: 2016 Annual Information Statement at
www.acnc.gov.au/2016AISchecklist
2. Read the 2016 Annual Information Statement guide at www.acnc.gov.au/2016AISguide
3. Some of the information in the 2016 Annual Information Statement will be prepopulated
from previous years. You may like to check your answers from the 2015 Annual
Information Statement. If you do not have a copy, you can view previous years’ Annual
Information Statements in the Charity Portal or on your charity’s entry page on the
Charity Register at www.acnc.gov.au/findcharity.
4. Complete the answers column in the worksheet – if you are unsure how to answer the
question, always refer to the guide.
5. If needed, ask your board or committee for approval.
6. Log into the Charity Portal at www.charity.acnc.gov.au
7. Copy and paste your answers in this form into the online 2016 Annual Information
Statement. Check all the answers – having a decimal point in the wrong place can lead
to errors in your statement, for example.
If you have any questions, contact our Advice Services staff by calling 13 ACNC (13 22 62) or
email [email protected].
The ACNC will not accept this worksheet as your charity’s Annual Information Statement
2016 Annual Information Statement worksheet
Number Question
1
ABN
2
Charity’s name
3
Are there any other names your
charity is known by?
4a
What address do you want the
ACNC to send all correspondence
(your address for service)?
Answer
Email preferred
4b
Who do you want the ACNC to use
as a primary contact (contact
person) for your charity?
title, family name, given name, other
given names, DOB, daytime phone
number, mobile phone number
5
What are your charity’s contact
details?
Email & business address that the
public can use to contact your charity
6
What is the size of your charity
based on its annual revenue for the
2016 reporting period?
Small, medium or large
7
Is your charity’s only registered
purpose advancing religion?
Yes/No
*If no, skip to Q8
7a
Could your charity be registered as
any other subtype?
Yes/No
*If yes, skip to Q8
The ACNC will not accept this worksheet as your charity’s Annual Information Statement
7b
Is your charity incorporated or
registered under certain
legislation?
Yes/No
*If yes, skip to Q8
7c
Has the ACNC allowed your charity
to report as part of a group?
Yes/No
*If yes, skip to Q8
7d
Is your charity (as a whole)
endorsed as a deductible gift
recipient (DGR) or does it operate
a DGR fund(s), authority(ies) or
institution(s) that had total revenue
of $250 000 or more in the
reporting period?
Yes/No
*If yes, skip to Q8
7e
Has your charity received more
than $100 000 in government
grants in the current reporting
period or in the previous two
reporting periods?
Yes/No
*If no, your charity is a basic religious
charity. You are not required to answer the
financial Questions (18 & 19).
8
Did your charity conduct any
activities in the 2016 reporting
period?
Yes/No
If you answered no for question 8
provide reasons.
You may then skip to question 12.
9
What were your charity’s main
activities in the 2016 reporting
period?
Refer to the list in the guide.
The ACNC will not accept this worksheet as your charity’s Annual Information Statement
This question is for charities that
undertake philanthropic and grantmaking activities, including private
and public ancillary funds,
testamentary or will trusts, and
income tax exempt trusts.
Write the estimated percentages.
They do not need to add up to 100%.
Estimate the percentage of your
charity’s grant funding in the 2016
reporting period that was
a) for capacity building of the
grant recipients
b) granted through a public or
open application process, or
similar
c) specifically for recipients in
rural an regional Australia
d) part of multi-year grants.
9 b.
This question is for charities that
undertake international activities.
What international activities did your
charity undertake?
10
Where did your charity conduct
activities during the 2016 reporting
period?
11
Describe how your charity’s
activities and outcomes helped
achieve your charity’s purpose.
12
Will your charity change or
introduce any activities in the 2017
reporting period?
Yes/No
If you answered yes for question
11, explain the types of activities
your charity intends to change or
introduce during the next reporting
period that are different to the 2016
reporting period.
13
Who was helped by your charity’s
activities in the 2016 reporting
period?
Refer to the list in the guide.
The ACNC will not accept this worksheet as your charity’s Annual Information Statement
This question is for charities that
support people with disabilities.
Yes/No/I don’t know
In the 2016 reporting period, did
your charity provide support and/or
services funded by the National
Disability Insurance Scheme?
This question is for charities that
support people with disabilities.
Yes/No/I don’t know
In the next reporting period, does
your charity intend to provide funded
support and/or services to
participants of the National Disability
Insurance Scheme?
14 a.
How many paid employees worked
for your charity during the last pay
period of the 2016 reporting
period?
Full time –
Part time –
Casual –
14 b.
How many unpaid volunteers
worked for your charity during the
2016 reporting period?
15
Complete an income statement and balance sheet extract for your charity
size, as set out in Attachment A.
16
Attach your financial report for the
2016 reporting period.
Make sure your financial report is
ready to upload in the Charity Portal.
This requirement is mandatory
for medium and large charities
and optional for small or exempt
charities.
16 a
Have you submitted this financial
report to a state/territory regulator?
16 b
Where did you submit your
financial report?
16 c
Why did you have to submit this
financial report?
My charity is an Incorporated
association/Cooperative/
Charitable fundraising organisation
The ACNC will not accept this worksheet as your charity’s Annual Information Statement
17
Are your governing documents,
responsible persons’ details and
registered subtypes current and
accurate on the ACNC register?
Yes/No
Attachment A: income statement and balance sheet extract
Complete the income statement and balance sheet extract relevant to your charity size:
Small: annual revenue of up to $250 000
Medium: annual revenue of $250 000 to $1 000 000
Large: annual revenue of $1 000 000 or more
Small charities
15
Did your charity use cash or
accrual accounting in the
2016 reporting period?
Cash/Accrual
Income statement for small charities
Revenue/receipts
a. Government grants
$
b. Donations and bequests
$
c. Other revenue/receipts
$
d. Total revenue/receipts (a + b + c)
$
e. Other income, if applicable
$
f.
$
Total income/receipts (d + e)
Expenses/payments
g. Employee expenses/payments
$
i.
$
Grants and donations made for use in Australia
The ACNC will not accept this worksheet as your charity’s Annual Information Statement
j.
Grants and donations made for use outside Australia
$
k. Other expenses/payments
$
l.
$
Total expenses/payments (g + i + j + k)
m. Net surplus/deficit (f - l)
$
Balance sheet
t. Total assets
$
y. Total liabilities
$
z. Net assets/liabilities (t – y)
$
Medium and large charities
15 a
Did your charity prepare a special
purpose financial statements or
general purpose financial
statements?
Special pupose/General purpose
15 b
Is your financial report consolidated
with more than one entity?
Yes/No
15 c i
Does the audit/review report,
provided with the annual financial
statements, include modified
opinion/conclusion?
Yes/No
15 c ii
What is the type of modified
opinion/conclusion?
Qualified/Adverse/Disclaimer of
opinion
15 d i
Did your charity have any related
party transactions?
Yes/No
15 d ii
Did your charity have documented
policies or processes about related
party transactions?
Yes/No
Note: totals in the income statement and balance sheet will be auto calculated when you
complete the Annual Information Statement in the Charity Portal.
Income statement – medium and large charities
The ACNC will not accept this worksheet as your charity’s Annual Information Statement
Gross income
a. Government grants
b. Donations and bequests
c. All other revenue
d. Total revenue (a + b + c)
e. Other income
f.
$
$
$
$
$
Total gross income (d + e)
$
Expenses
g. Employee expenses
h. Interest expenses *
i.
Grants and donations made for use in Australia
j.
Grants and donations made for use outside
Australia
k. All other expenses
l.
Total expenses (g + h + i + j + k)
m. Net surplus/deficit (f – l)
n. Other comprehensive income, if applicable
o. Total comprehensive income (m + n)
$
$
$
$
$
$
$
$
$
Balance sheet
Assets
p. Total current assets
q. Non-current loans receivable *
r.
Other non-current assets *
s. Total non-current assets (q + r) *
t.
Total assets (p +s )
$
$
$
$
$
Liabilities
u. Total current liabilities
$
The ACNC will not accept this worksheet as your charity’s Annual Information Statement
v. Non-current loans payable *
w. Other non-current liabilities
x. Total non-current liabilities (v + w) *
y. Total liabilities (u + x)
z. Net assets/liabilities (t – y)
$
$
$
$
$
* Line item applies to large charities only.
The ACNC will not accept this worksheet as your charity’s Annual Information Statement