Form FCERM 5A: Final statement of account – for land purchase and compensation
Final statement of account – for land
purchase and compensation
Risk management authority (RMA)
Please read through this form and write
clearly in the spaces provided.
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You only need to send us this form if you have
specified outstanding land-purchase or compensation
issues in part E of form FCERM5.
Please send this form (form FCRM5A) to the grant
administration team at the address shown in part H.
If the cost for each land purchase is more than
£10,000, or compensation is more than £5,000, all
payments must have a qualified valuer’s certificate and
location plan, in line with our grant memorandum. You
must send the valuer’s certificates and location plans
with this form.
Part A Scheme details
A1 Name of the scheme
A2 Name of your authority
Contents
Part A
Part B
Part C
Part D
Part E
Part F
Part G
Part H
Scheme details
Certificate of the authority
Financial statement
The Data Protection Act 1998
Certificate of the authority
Declaration
Payments
Contact us
Part B Certificate of the authority
An authorised technical officer of your authority must fill
this part in.
I confirm that our authority has completed this scheme in
line with the plans and specifications approved on behalf
of the Secretary of State.
Signature
A3 Grant approval number
For example LDW ....., CPW ....., IDB .....
(We will have given you this number and you must include it
here.)
A4 National project number (capital investment
programme reference number)
Date (DD/MM/YYYY)
Name
Title (Mr, Mrs, Miss, Other)
First name
Last name
A5 Grant rate
Job title
100%
45%
A6 Your authority
Local authority
Highways Agency
Internal Drainage Board
Water company
FCERM 5A Version 2, April 2016
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Form FCERM 5A: Final statement of account – for land purchase and compensation
Part C Financial statement
Approved
estimates
(£)
(a)
Contingencies not claimed on form FCERM5, for land
purchase and compensation only
(b)
Land-purchase payments and associated fees
(c)
Land-purchase payments included on FCERM5
(d)
Land-purchase payments being claimed now
Total final
spending
(£)
Breakdown of
final spending
(£)
Names of vendors, their professional advisors and amounts
being claimed
1
2
3
4
5
6
7
8
9
10
11
(e)
Compensation payments (including fees)
(f)
Compensation payments included on FCERM5
(g)
Compensation payments being claimed now
Names of claimants and their professional advisors
1
2
3
4
5
6
7
8
9
10
11
12
(h)
Spending eligible for grant
(a) + (d) + (g)
(i)
Total grant due
(h) x …… % grant rate from part A
(j)
Internal Drainage Boards only: amount after grant funded by
loan
FCERM 5A Version 2, April 2016
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Form FCERM 5A: Final statement of account – for land purchase and compensation
Part D The Data Protection Act 1998
Part F Declaration, continued
We, the Environment Agency, will process the information you
provide so that we can deal with your application, make sure
you keep to the conditions of the licence, permit or
registration, and process renewals.
We may also process or release the information to:
Name
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offer you documents or services relating to environmental
matters;
consult the public, public organisations and other
organisations (for example, the Health and Safety
Executive, local authorities, the emergency services, the
Department for Environment, Food and Rural Affairs) on
environmental issues;
carry out research and development work on
environmental issues;
provide information from the public register to anyone
who asks;
prevent anyone from breaking environmental law,
investigate cases where environmental law may have
been broken, and take any action that is needed;
assess whether customers are satisfied with our service,
and to improve our service; and
respond to requests for information under the Freedom of
Information Act 2000 and the Environmental Information
Regulations 2004 (if the Data Protection Act allows).
Title (Mr, Mrs, Miss, Other)
First name
Last name
Job title
Contact numbers, including the area code
Phone
Fax
Mobile
Email
.
.
Part G Payments
We may pass the information on to our agents or
representatives to do these things for us.
We will pay any balance of the grant funding for this claim to
your authority's bank.
Have your authority’s bank details changed since your last
payment?
Yes
No
Part E Certificate of the authority
Part H Contact us
Your Chief Executive Officer or authorised officer must
fill this part in.
I confirm the following:
The details in part C of this financial statement are
correct
We have kept to the conditions set out in the relevant
grant memorandum
We have clearly identified all amounts received and
receivable against the cost of this scheme
The grant has been spent properly and we have not
applied for any other public funding for the work (and will
not do so)
For Internal Drainage Boards only: we have used any
loan approved for funding this scheme to meet the cost
of this project only
We have applied for any balance of the grant funding for
this scheme
If you need help filling in this form, please contact the person
who sent you it or contact us as shown below.
If any of your authority’s bank’s details change, please send
details, in a separate letter, to:
Grant Administration Team
Environment Agency
Manley House
Kestrel Way
Sowton
Exeter
EX2 7LQ
The letter should be signed by your authorised Finance
Officer.
Telephone: 02030 252221
Email: [email protected]
Website: https://www.gov.uk/government/collections/floodand-coastal-defence-funding-for-risk-management-authorities
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Part F Declaration
Warning
If you make a false or inaccurate statement you may lose
your entitlement to grant funding.
Please tell us if you need information in a
different language or format (for example, in
large print) so we can keep in touch with you
more easily.
Signature
Date (DD/MM/YYYY)
FCERM 5A Version 2, April 2016
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Form FCERM 5A: Final statement of account – for land purchase and compensation
For Environment Agency use only
Findings and comments
Action required
Signature
Name
Title (Mr, Mrs, Miss, Other)
Date (DD/MM/YYYY)
First name
Last name
FCERM 5A Version 2, April 2016
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