Service ID: Date of previous report: Name of Approved Provider: Physical address of Approved Provider Street address: Suburb: State/Territory: Postcode: Key personnel for this report Title: Given name(s): Family name: Position: Contact phone: Email address: Name/proposed name of service: Physical address of service Street address: Suburb: State/Territory: Postcode: Is this report: Annual Pursuant to a request made by the Department ☐ ☐ A1. Please provide details of the provisionally allocated places. Date Type of Place Number Current Are these places Are these places provisional of places expiry date of linked to a capital linked to a Zero allocation the grant for Real Interest Loan was made provisionally construction or for construction or allocated redevelopment? redevelopment? places Y/N Y/N Total places
Service ID: Date of previous report: Name of Approved Provider: Physical address of Approved Provider Street address: Suburb: State/Territory: Postcode: Key personnel for this report Title: Given name(s): Family name: Position: Contact phone: Email address: Name/proposed name of service: Physical address of service Street address: Suburb: State/Territory: Postcode: Is this report: Annual ☐ Pursuant to a request made by the Department ☐ A1. Please provide details of the provisionally allocated places. Date provisional allocation was made Type of Place Number of places Current expiry date of the provisionally allocated places Are these places linked to a capital grant for construction or redevelopment? Y/N Are these places linked to a Zero Real Interest Loan for construction or redevelopment? Y/N Total places
14._progress_report_towards_being_in_a_position_to_provide_care_for_resident_03_03_17.docx