02-Mar-2022 _______________, 2022 Hon. Dennis K. Vandi Minister of Finance Ministry of Finance Treasury Building, George Street Freetown, Sierra Leone Your Excellency: Re: Republic of Sierra Leone - IDA Grant V4220-SL (Digital Sierra Leone) Additional Instructions: Disbursement and Financial Information Letter I refer to the Financing Agreement between the Republic of Sierra Leone (“Recipient”) and the International Bank for Reconstruction and Development and the International Development Association (“World Bank”) for the above-referenced Project. The General Conditions, as defined in the Financing Agreement, provide that the Recipient may from time to time request withdrawals of Grant1 amounts from the Grant Account2 in accordance with the Disbursement and Financial Information Letter, and such additional instructions as the World Bank may specify from time to time by notice to the Recipient. The General Conditions also provide that the Disbursement and Financial Information Letter may set out Project specific financial reporting requirements. This letter constitutes such Disbursement and Financial Information Letter (“DFIL”), and may be revised from time to time. I. Disbursement Arrangements, Withdrawal of Grant Funds, and Reporting of Uses of Grant Funds The Disbursement Guidelines for Investment Project Financing, dated February 2017, (“Disbursement Guidelines”), are available in the World Bank’s public website at https://www.worldbank.org and its secure website “Client Connection” at https://clientconnection.worldbank.org. The Disbursement Guidelines are an integral part of the DFIL, and the manner in which the provisions in the Disbursement Guidelines apply to the Grant is specified below. (i) Disbursement Arrangements  General Provisions (Schedule 1). The table in Schedule 1 sets out the disbursement methods which may be used by the Recipient, [and conditions], information on registration of authorized signatories, processing of Withdrawal Applications (including minimum value of applications and processing of advances), instructions on supporting documentation, and frequency of reporting on the Designated Account(s). 1 “Financing” means: (a) the Credit if the Financing Agreement provides for a Credit only; (b) the Grant if the Financing Agreement provides for a Grant only; or both the Credit and the Grant if the Financing Agreement provides for both a Credit and a Grant. 2 “Financing Account” means: (a) the Credit Account if the F inancing Agreement provides for a Credit only; (b) the Grant Account if the Financing Agreement provides for a Grant only; or (c) the Credit Account in respect of the Credit and the Grant Account in respect of the Grant if the Financing Agreement provides for a Credit and a Grant. 2 (ii) Withdrawal Applications Electronic Delivery3 The Recipient will deliver Withdrawal Applications (with supporting documents, “Applications”) electronically through the World Bank’s web-based portal “Client Connection” at https://clientconnection.worldbank.org. This option will be effected after the officials designated in writing by the Recipient who are authorized to sign and deliver Applications have registered as users of “Client Connection”. The designated officials will deliver Applications electronically by completing the Form 2380, which is accessible through “Client Connection”. By signing the Authorized Signatory Letter, the Recipient confirms that it is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to the World Bank by electronic means. The Recipient may exercise the option of preparing and delivering Applications in paperform on exceptional cases (including those where the Recipient encounters legal limitations), and which were previously agreed with the World Bank. By designating officials to use SIDC and by choosing to deliver the Applications electronically, the Recipient confirms through the Authorized Signatory Letter its agreement to: (a) abide by the Terms and Conditions of Use of Secure Identification Credentials in connection with Use of Electronic Means to Process Applications and Supporting Documentation, available in the World Bank 's public website at https://www.worldbank.org and “Client Connection”; and (b) to cause such officials to abide by those terms and conditions. II. Financial Reports and Audits 4 (i) Financial Reports The Recipient must prepare and furnish to the World Bank not later than forty-five (45) days after the end of each calendar quarter, interim unaudited financial reports (“IFRs”) for the Project covering the quarter. (ii) Audits. Each audit of the Financial Statements must cover the period of one fiscal year of the Recipient, commencing with the fiscal year in which the first withdrawal was made. The audited Financial Statements for each such period must be furnished to the World Bank not later than six (6) months after the end of such period. III. Other Important Information. For additional information on disbursement arrangements, please refer to the Loan Handbook available on the World Bank’s public website and “Client Connection”. The World Bank recommends that you register as a user of “Client Connection”. From this website you will be able to prepare and deliver Applications, monitor the near real-time status of the Grant, and retrieve related policy, financial, and procurement information. For more information about the website and registration arrangements, or if you have any queries in relation to the above, please contact the World Bank by email at askloans@worldbank.org using the above reference. 3 Section 11.01 (c) of the General Conditions. 4 Section 5.09 of the General Conditions. 3 Yours sincerely, ______________________________ Abdu Muwonge Country Manager for Sierra Leone Africa Western and Central Region Attachments 1. Form of Authorized Signatory Letter 2. Form of Interim unaudited Financial Report (IFR) With copies: Ministry of Finance Treasury Building George Street Freetown, Sierra Leone fsecretary@mof.gov.sl Ministry of Information and Communications 8th Floor, Youyi Building Brookfield Freetown, Sierra Leone minister@moic.gov.sl permanenet.secretary@moic.gov.sl 4 Schedule 1 : Disbursement Provisions A. Basic Information Country Republic Sierra Leone Closing Date Article III 3.03 of the Agreement Grant Recipient Republic of Sierra Leone V4220-SL Number Name of the Project Digital Sierra Leone Disbursement Four (4) months after the closing Deadline Date5 date B. Disbursement Methods and Supporting Documentation Disbursement Methods6 Methods Supporting Documentation7 Direct Payment Yes Records (Supplier Invoices/Copy of Receipts) Reimbursement Yes Allow Electronic SOE submission, Copies of Bank Statements, Statement of Expenditure, in the format provided in Attachment 2 of the DFIL Advance (into a Designated Yes DA-V: Interim Financial Report, in the format provided in Attachment 2 of the DFIL Account) Special Commitments No Not Applicable C. Designated Account(s)8 Type and Management Unit DA-V: Segregated – Managed by PFMU under MOF Ceiling DA-V: Variable Financial Institution - DA-V: To be determined DA-V: USD Currency Name DA-V: Quarterly DA-V: Forecast for two quarters as per Frequency of Reporting9 Amount IFRs D. Minimum Value of Applications10 The minimum value of applications for Direct Payment and Reimbursement is USD 50,000 equivalent. E. Authorized Signatures11 Withdrawal and Documentation Applications12 The form for Authorized Signatory Letter is provided in Attachment 1 of this letter. All Applications and its supporting documentation, and Authorized Signatory Letter will be electronically sent via the Bank’s system “Client Connection”. For notes in Schedule 1: Sections and subsections relate to the “Disbursement Guidelines for Investment Project Financing”, d ated February 2017. 5 Subsection 3.7 6 Section 2 7 Subsections 4.3 and 4.4 8 Sections 5 and 6 9 Subsection 6.3 10 subsection 3.5 11 Subsection 3.1 and 3.2 12 Subsection 3.3 and 3.4 5 F. Additional [Information][Instructions] None 6 Attachment 1 – Form of Authorized Signatory Letter [Letterhead] Ministry of Finance [Street address] [City] [Country] [DATE] International Development Association 1818 H Street, N.W. Washington, D.C. 20433 United States of America Attention: [Country Director]1 Dear [Country Director]: Re: IDA Grant No. _______-___ (name of Project) I refer to the [Credit] [Grant] Agreement (“Agreement”) between the International Bank for Reconstruction and Development and International Development Association (“World Bank”)[, acting as implementing of the]2 and [name of recipient] (“Recipient”), providing the above [Credit] [Grant]. For the purposes of Section 2.03 of the General Conditions as defined in the Agreement, any 3[one] of the persons whose authenticated specimen signatures appear below is authorized on behalf of the Recipient to sign Withdrawal Applications (“Application”) [and applications for a special commitment] under this [Credit] [Grant]. For the purpose of delivering Applications to the World Bank, including by electronic means, 4 [each] of the persons whose authenticated specimen signatures appears below is authorized on behalf of the Recipient, acting 5[individually] 6[jointly], to deliver Applications, and evidence in support thereof on the terms and conditions specified by the World Bank. This confirms that the Recipient is authorizing such persons to accept Secure Identification Credentials (SIDC) and to deliver the Applications and supporting documents to the World Bank by electronic means. In full recognition that the World Bank shall rely upon such representations and warranties, including without limitation, the representations and warranties contained in the Terms and 1 Instruction to Bank staff: please forward this letter to Country Lawyer for further processing (Recipient: please do not delete this note). 2 Instruction to the Recipient: add text in line with the Grant Agreement if applicable; if not applicable delete it. Please delete this footnote in final letter that is sent to the Associations 3 Instruction to the Recipient: stipulate if more than one person needs to sign Applications, and how many or which positions, and if any thresholds apply. Please delete this footnote in final letter that is sent to the Association. 4 Instruction to the Recipient: stipulate if more than one person needs to jointly sign Applications, if so, please indicate the actual number. Please delete this footnote in final letter that is sent to the Association. 5 Instruction to the Recipient: use this bracket if any one of the authorized persons may sign; if this is not applicable, please delete. Please delete this footnote in final letter that is sent to the Association. 6 Instruction to the Recipient: use this bracket only if several individuals must jointly sign each Application; if this is not applicable, please delete. Please delete this footnote in final letter that is sent to the Association. 7 Conditions of Use of Secure Identification Credentials in connection with Use of Electronic Means to Process Applications and Supporting Documentation (“Terms and Conditions of Use of SIDC”), the Recipient represents and warrants to the Association that it will cause such persons to abide by those terms and conditions. This Authorization replaces and supersedes any Authorization currently in the Association records with respect to this Agreement. [Name], [position] Specimen Signature: ____________________ [Name], [position] Specimen Signature: ____________________ [Name], [position] Specimen Signature: ____________________ Yours truly, / signed / ______________ 8 Attachment 2 - Interim unaudited Financial Statements Reference Information Reference value Country Sierra Leone Project Number Project Title IFR Reporting Quarter Quarter Ending ‐ Date IFR Reporting Currency USD Grant IDs reported in this IFR Enter the Grant IDs below First DA # Second DA # Grant ID1 GRANT REFERENCE Grant ID2 Grant ID3 Grant ID4 Grant ID5 Grant ID6 9 Country Sierra Leone Project 0 Number : IFR for the Quarter ending: 0‐ Jan‐ 00 Reporting Currency USD GRANT REFERENCE 0 0 0 0 0 Total Description Actual (USD) Actual (USD) Actual (USD) Actual (USD) Actual (USD) Actual (USD) Actual (USD) Cumulative to Cumulative to Cumulative to Cumulative to Cumulative to Cumulative to Cumulative to Current Quarter Year ‐To Date Date Current Quarter Year ‐To Date Date Current Quarter Year ‐To Date Date Current Quarter Year ‐To Date Date Current Quarter Year ‐To Date Date Current Quarter Year ‐To Date Date Current Quarter Year ‐To Date Date OPENING BALANCES (BOOK BALANCE) Designated Account 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Operating Account 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Advances from DA/OA & Petty Cash 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Other (please explain) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Opening Balance (A) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 SOURCES OF FUNDS Addl advances received from the World Bank 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 DA Receipts/Replenishment 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Direct Payments 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Special Commitments Payments 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Reimbursements 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Refunds 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Adjustments (if any) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Others (Please specify) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Sources of Funds (B) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total (A+B) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 USES OF FUNDS BY CATEGORY Category 1 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Category 2 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Category 3 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Category 4 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Category 5 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Category 6 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Category 7 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Category 8 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Category 9 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Category 10 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Sub‐Total Uses of Funds ( C ) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Refund of Preparation Advance 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Adjustments (if any) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Others (Please specify) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Uses of Funds (D) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 CLOSING BALANCES (BOOK BALANCE) Designated Account 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Operating Account 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Advances from DA/OA & Petty Cash 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Others (Please specify) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Closing Balance ( E ) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10 Country Sierra Leone Project Number: 0 IFR for the Quarter ending: 0‐Jan‐00 Reporting Currency USD Project Components and Activities ACTUAL AMOUNT PLANNED AMOUNT VARIANCE PAD Cumulative to Cumulative to Current Quarter Cumulative to Life of project Revised Life of Explain variance if greater than 15% for this sub‐ Current Quarter Year to Date date Current Quarter Year to Date date Year to Date date (Amt) Project * (Amt) component Component 1 Description Sub‐component 1.1 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 1.2 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 1.3 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 1.4 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Component 1: Total of Uses of Funds 0.00 0.00 0.00 0.00 0.00 0.00 Component 2 Description Sub‐component 2.1 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 2.2 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 2.3 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 2.4 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Component 2: Total of Uses of Funds 0.00 0.00 0.00 0.00 0.00 0.00 Component 3 Description Sub‐component 3.1 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 3.2 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 3.3 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 3.4 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Component 3: Total of Uses of Funds 0.00 0.00 0.00 0.00 0.00 0.00 Component 4 Description Sub‐component 4.1 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 4.2 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 4.3 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 4.4 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Component 4: Total of Uses of Funds 0.00 0.00 0.00 0.00 0.00 0.00 Component 5 Description Sub‐component 5.1 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 5.2 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 5.3 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 5.4 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Component 5: Total of Uses of Funds 0.00 0.00 0.00 0.00 0.00 0.00 Component 6 Description Sub‐component 6.1 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 6.2 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 6.3 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 6.4 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Component 6: Total of Uses of Funds 0.00 0.00 0.00 0.00 0.00 0.00 Component 7 Description Sub‐component 7.1 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 7.2 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 7.3 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 7.4 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Component 7: Total of Uses of Funds 0.00 0.00 0.00 0.00 0.00 0.00 Component 8 Description Sub‐component 8.1 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 8.2 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 8.3 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Sub‐component 8.4 0.00 0.00 0.00 0.00 0.00 0.00 #DIV/0! #DIV/0! #DIV/0! Component 8: Total of Uses of Funds 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL PROJECT EXPENDITURES 0.00 0.00 0.00 0.00 0.00 0.00 11 DA ACTIVITIES STATEMENT/FUNDS REQUIREMENT FROM WORLD BANK P GRANT GRANT 0 0 0 0 0 0 0 0 0 0 a REFERENC REFERENC r t i c u l a r s 0 0 0 0 0 0 0 0 0 0 0 0 PART I (Advances ‐ As per Client records) 1 Cumulative Advances up to end of last reporting quarter/period (less refunds 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2 Less: Cumulative expenditures paid up to end of last reporting period 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3 Outstanding Advances (book) to be accounted for at the end of last reporting quarter(1 minus 2) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PART II (Advances ‐ As per Bank Client Connection) 4 Cumulative Advances up to end of current reporting quarter/period (less refunds 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5 Less: Cumulative expenditures documented with WB up to end of current reporting period 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6 Outstanding Advances (ClientConnection) to be accounted for at the end of current reporting quarter(4 minus 5) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PART III (DA reconciliation) 7 Opening Advance (book) balance at beginning of current reporting quarter/period (same as item 3) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 8 Add: Advances received during reporting period 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9 Outstanding Advances to be accounted for at the end of the current reporting quarter(7 plus 8 ) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10 Less: Expenditures for current reporting quarter/period(paid from DA) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 11 Add: Adjustments, if any 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 12 Less: Adjustments, if any 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 13 Closing Advance (as per project books of records) balance at end of current reporting quarter/period(9 minus 10 plus 11 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 minus 12 ) PART IV (Bank reconciliation) 14 Closing DA balance (as per bank statement) at end of current reporting period, as of xxxx 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 15 Add/subtract: cumulative adjustments, if any 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 16 Minus: Expenditures for the current reporting period that have not been debited to the DA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 17 Closing DA balance (as per project books of record) balance (14 plus/minus 15 minus 16) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PART V (Funds requested) 12 18 Total forecasted expenditures from the DA in next 6 months 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 19 Less: Closing Bank balance at the end of current reporting period(item 14 above) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 20 Less: Withdrawal applications in process with the Bank 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 21 Fund request from WB for next 6 months (18 minus 19 minus 20) 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00