Contribution Funds for Non-governmental Organizations - a Handbook

Appendix C: PA-5 Form

File Number:

Department of Justice Canada

Contributions to:

Review Engagement Report

We have reviewed the Statement of Revenues and Expenditures (PA-1 form) of (Name of Recipient) calculated in accordance with the provisions of the Contribution Agreement signed on (Date) for the period from (Date) to (Date) in the amount of $ (Total actual claimed expenses). Our review was made in accordance with Canadian generally accepted standards for review engagements and, accordingly, consisted primarily of enquiry, analytical procedures and discussion related to information supplied to us by the recipient.

A review does not constitute an audit and, consequently, we do not express an audit opinion on the Statement.

Based on our review, nothing has come to our attention that causes us to believe that the Statement of Revenues and Expenditures (PA-1) is not, in all material respect, in accordance with the basis of accounting as described in the Agreement.

This Statement has been prepared in accordance with the CPA Canada handbook - Accounting (Part II, III & V), is solely for the information and use of the Minister of Justice and Attorney General of Canada, for the purpose of monitoring expenditures of its funding program. The Statement of Revenues and Expenditures (PA-1 form) is not intended to be and should not be used by anyone other than the specified users, or for any other purpose.

Please respond to the following questions:

1. Was the claim adjusted for the GST/HST rebate?

  • Yes
  • No

2. Do you agree with the amounts stated on the Statement of Revenues and Expenditures (PA-1) are materially correct?

  • Yes
  • No

3. When completing the Statement of Revenues and expenditures (PA-1 )and this form (PA-5), did you compare them with the budget approved in the Agreement?

  • Yes
  • No

4. Did you have to make any material adjustments during your review?

  • Yes
  • No

Note: If you responded No to questions 1 to 3 or Yes to question 4, please provide an explanation:

Print Name:

Telephone No: Ext:

Signed by:

Date:

E-mail address:

Title:(Certified Accountant (CGA, CMA, CA) or (Director of Finance *)

Public Accountancy Permit Number:

Accounting Firm:

* Only Applicable to Provincial / Territorial Governments or University Establishments

PA-5 (rev. 3/2015)

Date modified: