ADB-JFPR Support to Local Government Revenue Generation

and Land Administration Reforms Project

GRANT APPL!AT"N T#$PLAT#
tem %&' Grant Fund Sc(eme and Basic nformation of Proponents)Partners
Area*s+ of nterest of t(e Proponent LG,
LAM Agency Coordination and Governance (required)
LAM Systems and Database Development
Revenue Systems
GIS !LIS
LAMS
R"SAS
CIM and GIS Applications
#roperty $aluation and Revenue Management
Land Management and Investment #lanning
Land %enure #ro&iling
tem -&' $ain Proponent *Lead mplementin. A.enc/)"r.ani0ation+
Main #roponent
(Lead Implementing Agency)
#rincipalinc'arge &rom Main
#roponent
#osition
#rincipal Contact Address
#'one (umbers (include Area
Code)
)a*
"mail Address
Signature o& #rincipalin
c'arge
Section A1 Basic Project and Proponent nformation
tem 2&'a !o-Proponent *Principal Partner A.enc/)"r.ani0ation+
Co#roponent (#rincipal
#artner Agency)
#rincipalinc'arge &rom Co
#roponent
#osition
#rincipal Contact Address
#'one (umbers (include Area
Code)
)a*
"mail Address
Signature o& #rincipalin
c'arge
tem 2&'3 !o-Proponent *"t(er)Additional Proponents+
Co#roponent (#rincipal
#artner Agency)
#rincipalinc'arge &rom Co
#roponent
#osition
#rincipal Contact Address
#'one (umbers (include Area
Code)
)a*
"mail Address
Signature o& #rincipalin
c'arge
tem 4&' Status of #5istin. LA$ services and s/stems
Status of LA$ Services and S/stems 6es No Description
Cadastral Inde* Maps
Land %itles Records and Database In&ormation System
Land In&ormation Management System
Computeri+ed %a* Assessment and Mapping
#'ysical )acility &or Colocation or ,neStop S'op
,perations
,t'ers
Note1 Documentation and Su3stantiation of !ommitment and
A.reements)Partners(ips *must 3e su3mitted to.et(er 7it( t(is Accomplis(ed
Form+
tem %&' "fficial Letters of ntent from Proponents *Lead mplementin. and !o-
Proponent A.enc/)"r.anisation+
Documentation 6es No
-. Main #roponent/Lead Implementing Agency/,rganisation
0. Co#roponent
1. ,t'er #roponents
tem -&' Statement of !ommitments and Accounta3ilit/
a& $ain Proponent *Lead mplementin. A.enc/)"r.anisation+
Documentation 6es No
-. Letter o& Aut'ority/"ndorsement to #articipate in AD23)#R Grant
)acility &rom Agency/,rganisation4s approving aut'ority (i.e. 2oard5
or Regional ,&&ice/Director)
0. Sanggunian Resolution (&or LG!s)
3& !o-Proponent
Documentation 6es No
-. Letter o& Aut'ority/"ndorsement to #articipate in AD23)#R Grant
)acility &rom Agency/,rganisation4s approving aut'ority (i.e. 2oard5
or Regional ,&&ice/Director)
Section B1 Partners(ip !ommitments and A.reements
%&' Project Bac8.round1 *Describe t'e reasons &or underta6ing t'e proposed pro7ect by
providing brie& but speci&ic ans8ers to t'e questions belo8. #lease use anot'er s'eet o&
paper i& space is insu&&icient. )
a. 9(at is t(e primar/ local revenue .eneration and land administration pro3lem
3ein. addressed 3/ t(e Project9
b. 9(at (as 3een t(e previous 7or8 done 3/ t(e Proponent in t(is area:
c. Descri3e t(e main si.nificance and 3enefit of t(e proposed project: * if possi3le
;uantif/+
d. 9(at are t(e e5pected direct or indirect 3enefits of t(e introduction of t(e
project:
e. Are t(ere ot(er related .overnment or donor-funded local revenue .eneratio<n
and LA$ projects or pro.rams t(at 7ill 3e supported 3/ t(e Project:
-&' mplementin. "r.ani0ation& *Describe brie&ly t'e proponent organisation4s vision
missiongoals in relation to improving LAM services in t'e area. %'e proponent can
include relevant documents5 i.e. Sanggunian resolution5 e*ecutivelegislative agenda5 or
policy statements.)
2&' Project "3jectives& (Identi&y at most 1 ob7ectives o& t'e #ro7ect+
4&' #5pected Results& *Describe t'e e*pected pro7ect outputs5 development bene&its and
impacts (institutional5 gender5 &inancial5 environmental) o& t'e #ro7ect
Section !1 Project Description
=&' nnovative Features& *Identi&y t'e innovative &eature o& t'e #ro7ect t'at 8ould be
introduced in t'e e*isting local revenue generation and LAM system in t'e area)
>&' Proposed $et(odolo./ and Approac( *#rovide a brie& statement o& 'o8 t'e
pro7ect 8ill be conducted5 su&&icient to 7usti&y t'e indicative time and budget estimates)
a. Describe t'e pro7ect components including t'e tec'nical and &inancial design
and analysis (i& applicable).
b. Describe possible ris6s to ac'ieving t'e planned outcomes5 including
environmental ris6 (see also Section 0.:) and 'o8 t'ey 8ill be addressed.
c. Describe t'e monitoring and evaluation &rame8or6/ sc'eme.
d. #resent t'e #ro7ect Implementation #lan / Sc'eme.
?&' Project $ana.ement&*#rovide a brie& statement o& 'o8 t'e pro7ect 8ill be
managed)
a. Identi&y t'e number and members o& t'e #roposed #ro7ect Implementation
%eam and describe t'eir tas6s5 &unctions and responsibilities5 status o&
assignment (&ulltime/parttime)5 status o& employment (regular/contracted);
Name "ri.inatin.
A.enc/
Position Tas8)Assi.nment
in P,
Status of
Assi.nment
Status of
#mplo/ment
b. Describe < di&&erentiate t'e roles and responsibilities o& t'e proponent
organi+ation5 t'e bene&iciary organi+ation and t'e collaborating organi+ations;
@&' !ommunit/ Participation *Describe t'e bene&iciary group/ community5 t'eir role in
t'e pro7ect and t'e c'ange impact t'e pro7ect 8ill 'ave on t'em)
<&' Gender and Social ssues *Indicate 'o8 t'e pro7ect outcomes 8ill a&&ect gender
roles or be integrated into e*isting roles or its e&&ect on e*isting relations'ips/roles o& men
and 8omen in t'e area)
%'&' Sustaina3ilit/ $ec(anism
(Indicate 'o8 it is envisaged or e*pected t'at t'e outputs mig't be sustained at t'e
institutional level or by bene&iciaries)
Section D1 ndicative Bud.et
Attac( t(e Project ndicative Bud.etA includin. t(e follo7in.1
a. %otal #ro7ect Cost5 AD23)#R Grant support5 Counterpart
b. = Counterpart5 = Administration5 Cost per bene&iciary
c. Grants and Counterpart !tili+ation Sc'edule
d. %ranc'e and Milestone Sc'edule
e. )inancial pro7ectionscas' &lo85 income statement relevant to t'e pro7ect
type
Note> #ro7ect administrative support cost s'ould be &ully covered by local counterpart
&und.