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[]
[]
[{"$nulls":12}," Relevé des revenus et des dépenses et demande de paiement – Jeunes volontaires"]
{"$rows_empty":8}
[null,"Nom du projet :"]
[]
[{"$nulls":23},"Année–Mois–Jour",{"$nulls":10},"Année–Mois–Jour"]
[]
[null,"Numéro de contrat :",{"$nulls":16},"Date de début :",{"$nulls":11},"Date de fin :"]
[]
[]
[]
[]
[]
["Revenus et dépenses",{"$nulls":10},"Période couverte par ce relevé :",{"$nulls":18},"au"]
[]
[]
["Description des revenus",{"$nulls":16},"Revenus\nprévus (A)",{"$nulls":5},"Revenus\ncumulatifs (B)",{"$nulls":5},"Revenus pour la\npériode couverte (C)",{"$nulls":5},"Revenus à venir\n(D)"]
[]
[]
[]
["Subvention Emploi-Québec",{"$nulls":34},""]
[]
[]
["Revenus générés par le projet",{"$nulls":34},""]
[]
[]
["Revenu total",{"$nulls":16},"",{"$nulls":5},"",{"$nulls":5},"",{"$nulls":5},""]
[]
[]
["Description des dépenses",{"$nulls":16},"Dépenses\nprévues (E)",{"$nulls":5},"Dépenses\ncumulatives (F)",{"$nulls":5},"Dépenses pour la\npériode couverte (G)",{"$nulls":5},"Montants disponibles pour les dépenses à venir (H)"]
[]
[]
[]
["1. Frais de fonctionnement"]
[]
[]
["Locaux",{"$nulls":34},""]
[]
[]
["Électricité, eau, chauffage et entretien",{"$nulls":34},""]
[]
[]
["Téléphone",{"$nulls":34},""]
[]
[]
["Frais bancaires",{"$nulls":34},""]
[]
[]
["Achat ou location d'équipement",{"$nulls":34},""]
[]
[]
["Matériel et fournitures de bureau",{"$nulls":34},""]
[]
[]
["Assurance responsabilité civile",{"$nulls":34},""]
[]
[]
["Frais de déplacement",{"$nulls":34},""]
[]
[]
["Autres (précisez) :",{"$nulls":34},""]
[]
[]
[{"$nulls":35},""]
[]
[]
[{"$nulls":35},""]
[]
[]
[{"$nulls":35},""]
[]
[]
[{"$nulls":35},""]
[]
[]
[{"$nulls":35},""]
[]
[]
[{"$nulls":35},""]
[]
[]
["Total 1",{"$nulls":16},"",{"$nulls":5},"",{"$nulls":5},"",{"$nulls":5},""]
[]
[]
["2. Frais de formation"]
[]
[]
["Activités de formation",{"$nulls":34},""]
[]
[]
["Frais de déplacement",{"$nulls":34},""]
[]
[]
["Frais de garde",{"$nulls":34},""]
[]
[]
["Total 2",{"$nulls":16},"",{"$nulls":5},"",{"$nulls":5},"",{"$nulls":5},""]
[]
[]
["Total (1) + (2)",{"$nulls":16},"",{"$nulls":5},"",{"$nulls":5},"",{"$nulls":5},""]
[]
[]
["Demande de paiement et déclarations"]
[]
[]
["   Pour la prochaine période, nous demandons le versement d'un paiement total de",{"$nulls":33},", soit un montant de"]
[]
[]
[{"$nulls":8}," pour les frais de fonctionnement et un montant de",{"$nulls":23}," pour les frais de formation."]
[]
[]
["   Nous déclarons que les renseignements fournis sont exacts et complets."]
[]
[]
[]
[]
[]
[null,"Date",{"$nulls":5},"Signature participant ou du représentant des participants",{"$nulls":14},"Date",{"$nulls":6},"Signature du mentor"]
[]
["Réservé à Emploi-Québec"]
[]
[]
[null,"Dépenses acceptées pour la période couverte :",{"$nulls":22},"Montant versé à ce jour : "]
[]
[]
[null,"Montant demandé par le ou les participants :",{"$nulls":22},"Paiement à effectuer :"]
[]
[]
[null,"Commentaires :"]
[]
[]
[]
[]
[null,"Représentant d'Emploi-Québec :"]
[]
[{"$nulls":12},"Date",{"$nulls":8},"Signature"]
[]
[]
["Ministère de l'Emploi et de la Solidarité sociale"]
[]
[]
["EQ-6191 (06-2013)"]