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)You will see the reporting fields once you select the number of outcomes. If you have more than three metrics you would like to report, you can submit multiple assessments.[Please select]123OUTCOMESImpact investments intentionally aim to create positive change, often in several ways. We want information about the main outcomes and metrics, you are working towards. Please fill in one section for each.Main Outcome 1Please provide data to each field separately. Please add only one metric to one outcome.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 Realized if the outcome is actual, and Forecasted if the outcome is an estimate for the reporting period[Please select]RealizedForecastedMetric: What is the output or outcome indicator?(Required)For example, "Number of affordable housing units financed"Unit(Required)For example, "Houses"Realized level of the indicator(Required)Please provide the realized quantitative value here (for the metric above), such as 50Forecasted level of the indicator(Required)Please provide the expected quantitative value here (for the metric above), such as 50BaselineWhat level of outcome was experienced by the main stakeholder prior to engaging with, or otherwise being affected by, you?TargetIf there is a target level for the metric, please state with the target year. For example, 1,000 houses by 2030Main 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. Women 2SLGBTQIA+ Gender-Diverse: Agender Gender-Diverse: Non-Binary Gender-Diverse: Other Black People Indigenous Peoples: First Nations Indigenous Peoples: Inuit Indigenous Peoples: Metis Immigrants and Newcomers Lone Parent Families Nonprofits and Social Enterprises Northern Canadian Communities Official Language Minority Groups People on Low Income People Living with a Disability People without Advanced Educational Qualification People Living in Rural and Remote Areas Refugees and Internally Displaced People Seniors Survivors of Domestic Violence, Sexual assault, Abuse or Stalking Youth and Children Other Racialized Peoples People living with disability People Living with Cognitive or Mental Health Related Issues People Living with Physical, Sensory or Pain Related Disabilities People Living with Terminal or Chronic Illness/Diseases Other Specific Target Population(Required)Please provide details if you select Other Racialized Peoples 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]YesNoComments regarding Outcome 1 (if any)Main Outcome 2Please provide data to each field separately. Please add only one metric to one outcome.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 Realized if the outcome is actual, and Forecasted if the outcome is an estimate for the reporting period[Please select]RealizedForecastedMetric: What is the output or outcome indicator?(Required)For example, "Emissions avoided"Unit(Required)For example, "Metric tonnes of CO2eq"Realized level of the indicator(Required)Please provide the realized quantitative value here (for the metric above), such as 1,000Forecasted level of the indicator(Required)Please provide the expected quantitative value here (for the metric above), such as 1,000BaselineWhat level of outcome was experienced by the main stakeholder prior to engaging with, or otherwise being affected by, you?TargetIf there is a target level for the metric, please state with the target year. For example, 50 tCO2eq by 2030Main 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. Women 2SLGBTQIA+ Gender-Diverse: Agender Gender-Diverse: Non-Binary Gender-Diverse: Other Black People Indigenous Peoples: First Nations Indigenous Peoples: Inuit Indigenous Peoples: Metis Immigrants and Newcomers Lone Parent Families Nonprofits and Social Enterprises Northern Canadian Communities Official Language Minority Groups People on Low Income People Living with a Disability People without Advanced Educational Qualification People Living in Rural and Remote Areas Refugees and Internally Displaced People Seniors Survivors of Domestic Violence, Sexual assault, Abuse or Stalking Youth and Children Other Racialized Peoples People living with disability People Living with Cognitive or Mental Health Related Issues People Living with Physical, Sensory or Pain Related Disabilities People Living with Terminal or Chronic Illness/Diseases Other Specific Target Population(Required)Please provide details if you select Other Racialized Peoples 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]YesNoComments regarding Outcome 2 (if any)Main Outcome 3Please provide data to each field separately. Please add only one metric to one outcome.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 Realized if the outcome is actual, and Forecasted if the outcome is an estimate for the reporting period[Please select]RealizedForecastedMetric: What is the output or outcome indicator?(Required)For example, "Capital invested in women-led companies"Unit(Required)For example, "CAD million"Realized level of the indicator(Required)Please provide the realized quantitative value here (for the metric above), such as 30Forecasted level of the indicator(Required)Please provide the expected quantitative value here (for the metric above), such as 30BaselineWhat level of outcome was experienced by the main stakeholder prior to engaging with, or otherwise being affected by, you?TargetIf there is a target level for the metric, please state with the target year. For example, $100M by 2030Main 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. Women 2SLGBTQIA+ Gender-Diverse: Agender Gender-Diverse: Non-Binary Gender-Diverse: Other Black People Indigenous Peoples: First Nations Indigenous Peoples: Inuit Indigenous Peoples: Metis Immigrants and Newcomers Lone Parent Families Nonprofits and Social Enterprises Northern Canadian Communities Official Language Minority Groups People on Low Income People Living with a Disability People without Advanced Educational Qualification People Living in Rural and Remote Areas Refugees and Internally Displaced People Seniors Survivors of Domestic Violence, Sexual assault, Abuse or Stalking Youth and Children Other Racialized Peoples People living with disability People Living with Cognitive or Mental Health Related Issues People Living with Physical, Sensory or Pain Related Disabilities People Living with Terminal or Chronic Illness/Diseases Other Specific Target Population(Required)Please provide details if you select Other Racialized Peoples 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]YesNoComments regarding Outcome 3 (if any)OTHER INFORMATIONEmail(Required) General CommentsNameThis field is for validation purposes and should be left unchanged.
