Please enable JavaScript in your browser to complete this form.Name of the Organization/Rent Bank *Name of Person Completing the Report *FirstLastIn case a follow up question or clarification is needed.Email of Person Completing the Report *In case a follow up question or clarification is needed.Reporting Period *First Quarter (April 1 - June 30)Second Quarter (July 1 - Sept 30)Third Quarter (Oct 1 - December 31)Executive Summary (4-6 bulleted points) *This is meant to be a summary capturing the highlights of what has taken place over the past quarter. This can include major activities, trends or developments within your rent bank. Bulleted points are acceptable.Learning this Quarter *What is a challenge that you faced this quarter? How did you address it? What did you learn as a result?Quarterly Metrics# of Inquiries *measured by phone calls, emails, in person visits# of Pre-Assessments *If applicable, we understand all sites do not use pre-assessments at this time. # of Applications *# of Loans Approved *# of People Impacted *The total number of people within a household that benefited from a rent bank loan.# of People Assisted with Supplemental Services *The number of people who were provided an additional service at your agency. (i.e. financial literacy, food hamper, clothing, legal aid, counselling, tenancy-landlord mediation, residential tenancy information)# of People Referred for Supplemental Services *The number of people who were referred to an additional service in your community. (i.e. financial literacy food hamper, clothing, legal aid, counselling, tenancy -landlord mediation, residential tenancy information)Loan Capital - Opening Balance *What was the total dollar amount of loan capital available on the first day of the quarter? Loan Capital Issued *What is the total dollar ($) amount of funds issued for loans this quarter?Loan Capital Repaid *What is the total dollar ($) amount of repaid loans collected this quarter?Loan Capital - Closing Balance *What was the total dollar ($) amount of loan capital available on the last day of the quarter?Loan Repayment % (1 decimal point. i.e. 52.1) *Calculation: $ received/$ expected to be repaid X 100 = ____%. NOTE: If a loan is deferred then it is not expected to be repaid that month; only include payment you expected in your calculation. Other Comments, Tends or Observations (Optional)Is there anything else you want to tell us from this past quarter? Use bulleted points if you prefer.NameSubmit