Impact Reporting – Outcomes Assessment REPORTING: Operations Assessment | Outcomes Assessment Need help? reporting@rallyassets.com OVERVIEWThis assessment concerns:(Required) An investee within a fund (such as an underlying holding) A portfolio of investments (fund or product level) Investee Name(Required)Fund the investment is held within(Required)Start date of the reporting period for this assessment(Required) MM slash DD slash YYYY End date of the reporting period for this assessment(Required) MM slash DD slash YYYY Comments regarding the reporting periodHow many main outcomes do you have to monitor impact performance of this investment?(Required)Up to three. If you have more than three main outcomes and metrics you would like to report, let us know.[Please select]123OUTCOMESImpact investments intentionally aim to create positive change, often in several ways. We want information about the three main outcomes and metrics, you are working towards. Please fill in one section for each.Main Outcome 1We have three sections for three outcomes and metrics. Please provide data to each separately. Please add one outcome to each section.The social or environmental outcome you seek to achieve(Required)For example, improving access to affordable housing and quality of lifeMain Impact Area(Required)Choose one. Affordable Housing Arts and Culture Biodiversity and Ecosystem Conservation Clean Energy Climate Adaptation and Resilience Climate Change Mitigation Energy Access Energy Efficiency Financial Inclusion Food Security Green Buildings Marine Resources Conservation and Management Natural Resources Conservation Nutrition Pollution Prevention Quality Education Quality Healthcare Quality Jobs Racial Equity Resilient Infrastructure Smallholder Agriculture Sustainable Agriculture Sustainable Forestry Sustainable Land Management Sustainable Water Management Waste Management Water, Sanitation, and Hygiene Other Status of the outcome(Required)[Please select]RealizedForecastedMetric: What is the output or outcome indicator?(Required)For example, number of affordable houses financedLevel of outcome the experienced by the main stakeholder during the reporting period(Required)Please provide the realized quantitative value here (for the metric above)Baseline of the outcome experienced by the main stakeholder during the reporting periodWhat level of outcome was experienced by the main stakeholder prior to engaging with, or otherwise being affected by, you?Level of the outcome estimated to be experienced by the main stakeholder per annum(Required)Please provide the expected quantitative value here (for the metric above)Baseline of the outcomeWhat level of outcome was experienced by the main stakeholder prior to engaging with, or otherwise being affected by, you?Main Stakeholder(Required)Who is your work aiming to positively impact primarily?[Please select]EnvironmentPeople: No specific targeted population groupPeople: Specific targeted population groupSpecific Target Population(Required)You can choose more than one. Charities and Nonprofits Immigrants and Newcomers Indigenous Peoples Marginalized People People of Colour People on Low Income Refugees and Internally Displaced People Rural People Seniors Women Youth and Children Other Other Specific Target Population(Required)Please provide details if you select Other for specific target population.Geography of the stakeholder(Required) Global Canada US Other Other countryPlease provide details if you select Other for geography.Geographic target province/territories(Required)Only for Canada. Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Select AllExpected duration of the outcome (years)How long the outcome will continue to occur?Have you identified the relevant SDGs?(Required)[Please select]YesNoWhich SDG(s) is this specific metric aligned to?(Required)You can choose more than one SDG. SDG 1: No Poverty SDG 2: Zero Hunger SDG 3: Good Health and Well-being SDG 4: Quality Education SDG 5: Gender Equality SDG 6: Clean Water and Sanitation SDG 7: Affordable and Clean Energy SDG 8: Decent Work and Economic Growth SDG 9: Industry, Innovation and Infrastructure SDG 10: Reduced Inequality SDG 11: Sustainable Cities and Communities SDG 12: Responsible Consumption and Production SDG 13: Climate Action SDG 14: Life Below Water SDG 15: Life on Land SDG 16: Peace and Justice Strong Institutions SDG 17: Partnerships to Achieve the Goals Have you identified the relevant SDG targets and indicators?(Required)For each SDG, there are multiple SDG targets and indicators. Full list is available here: https://unstats.un.org/sdgs/indicators/indicators-list/[Please select]YesNoMain Outcome 2We have three sections for three outcomes and metrics. Please provide data to each separately.The social or environmental outcome you seek to achieve(Required)For example, reducing emissions and achieving energy efficiencyMain Impact Area(Required)Choose one. Affordable Housing Arts and Culture Biodiversity and Ecosystem Conservation Clean Energy Climate Adaptation and Resilience Climate Change Mitigation Energy Access Energy Efficiency Financial Inclusion Food Security Green Buildings Marine Resources Conservation and Management Natural Resources Conservation Nutrition Pollution Prevention Quality Education Quality Healthcare Quality Jobs Racial Equity Resilient Infrastructure Smallholder Agriculture Sustainable Agriculture Sustainable Forestry Sustainable Land Management Sustainable Water Management Waste Management Water, Sanitation, and Hygiene Other Status of the outcome(Required)[Please select]RealizedForecastedMetric: What is the output or outcome indicator?(Required)For example, CO2eq emissions avoided (in metric tonnes)Level of the outcome experienced by the main stakeholder during the reporting period(Required)Please provide the realized quantitative value here (for the metric above)Baseline of the outcome experienced by the main stakeholder during the reporting periodWhat level of outcome was experienced by the main stakeholder prior to engaging with, or otherwise being affected by, you?Level of the outcome estimated to be experienced by the main stakeholder per annum(Required)Please provide the expected quantitative value here (for the metric above)Baseline of the outcomeWhat level of outcome was experienced by the main stakeholder prior to engaging with, or otherwise being affected by, you?Main Stakeholder(Required)Who is your work aiming to positively impact primarily?[Please select]EnvironmentPeople: No specific targeted population groupPeople: Specific targeted population groupSpecific Target Population(Required)You can choose more than one. Charities and Nonprofits Immigrants and Newcomers Indigenous Peoples Marginalized People People of Colour People on Low Income Refugees and Internally Displaced People Rural People Seniors Women Youth and Children Other Other Specific Target Population(Required)Please provide details if you select Other for specific target population.Geography of the stakeholder(Required) Global Canada US Other If other(Required)Country or regionGeographic target province/territories(Required)Only for Canada. Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Select AllExpected duration of the outcome (years)How long the outcome will continue to occur?Have you identified the relevant SDGs?(Required)[Please select]YesNoWhich SDG(s) is this specific metric aligned to?(Required)You can choose more than one SDG. SDG 1: No Poverty SDG 2: Zero Hunger SDG 3: Good Health and Well-being SDG 4: Quality Education SDG 5: Gender Equality SDG 6: Clean Water and Sanitation SDG 7: Affordable and Clean Energy SDG 8: Decent Work and Economic Growth SDG 9: Industry, Innovation and Infrastructure SDG 10: Reduced Inequality SDG 11: Sustainable Cities and Communities SDG 12: Responsible Consumption and Production SDG 13: Climate Action SDG 14: Life Below Water SDG 15: Life on Land SDG 16: Peace and Justice Strong Institutions SDG 17: Partnerships to Achieve the Goals Have you identified the relevant SDG targets and indicators?(Required)For each SDG, there are multiple SDG targets and indicators. Full list is available here: https://unstats.un.org/sdgs/indicators/indicators-list/[Please select]YesNoMain Outcome 3We have three sections for three outcomes and metrics. Please provide data to each separately.The social or environmental outcome you seek to achieve(Required)For example, diversifying social finance market by supporting women entrepreneursMain Impact Area(Required)Choose one. Affordable Housing Arts and Culture Biodiversity and Ecosystem Conservation Clean Energy Climate Adaptation and Resilience Climate Change Mitigation Energy Access Energy Efficiency Financial Inclusion Food Security Green Buildings Marine Resources Conservation and Management Natural Resources Conservation Nutrition Pollution Prevention Quality Education Quality Healthcare Quality Jobs Racial Equity Resilient Infrastructure Smallholder Agriculture Sustainable Agriculture Sustainable Forestry Sustainable Land Management Sustainable Water Management Waste Management Water, Sanitation, and Hygiene Other Status of the outcome(Required)[Please select]RealizedForecastedMetric: What is the output or outcome indicator?(Required)For example, volume of investment (in CAD) dedicated to women foundersLevel of the outcome experienced by the main stake holder during the reporting period(Required)Please provide the realized quantitative value here (for the metric above)Baseline of the outcome experienced by the main stakeholder during the reporting periodWhat level of outcome was experienced by the main stakeholder prior to engaging with, or otherwise being affected by, you?Level of the outcome estimated to be experienced by the main stakeholder per annum(Required)Please provide the expected quantitative value here (for the metric above).Baseline of the outcomeWhat level of outcome was experienced by the main stakeholder prior to engaging with, or otherwise being affected by, you?Main Stakeholder(Required)Who is your work aiming to positively impact primarily?[Please select]EnvironmentPeople: No specific targeted population groupPeople: Specific targeted population groupSpecific Target Population(Required)You can choose more than one. Charities and Nonprofits Immigrants and Newcomers Indigenous Peoples Marginalized People People of Colour People on Low Income Refugees and Internally Displaced People Rural People Seniors Women Youth and Children Other Other Specific Target Population(Required)Please provide details if you select Other for specific target population.Geography of the stakeholder(Required) Global Canada US Other If other(Required)Country or regionGeographic target province/territories(Required)Only for Canada. Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Select AllExpected duration of the outcome (years)Have you identified the relevant SDGs?(Required)[Please select]YesNoWhich SDG(s) is this specific metric aligned to?(Required)You can choose more than one SDG. SDG 1: No Poverty SDG 2: Zero Hunger SDG 3: Good Health and Well-being SDG 4: Quality Education SDG 5: Gender Equality SDG 6: Clean Water and Sanitation SDG 7: Affordable and Clean Energy SDG 8: Decent Work and Economic Growth SDG 9: Industry, Innovation and Infrastructure SDG 10: Reduced Inequality SDG 11: Sustainable Cities and Communities SDG 12: Responsible Consumption and Production SDG 13: Climate Action SDG 14: Life Below Water SDG 15: Life on Land SDG 16: Peace and Justice Strong Institutions SDG 17: Partnerships to Achieve the Goals Have you identified the relevant SDG targets and indicators?(Required)For each SDG, there are multiple SDG targets and indicators. Full list is available here: https://unstats.un.org/sdgs/indicators/indicators-list/[Please select]YesNoOTHER INFORMATIONEmail(Required) General CommentsPhoneThis field is for validation purposes and should be left unchanged.
