BHH Invest 4 SMall Grant Application Form



57150-20955The Invest4 Grant Programme Small Grant (less than ?5,000) Application Form 0The Invest4 Grant Programme Small Grant (less than ?5,000) Application Form D Hub Investment Fund Please note that to fully assess your application, this form and supporting documents must be fully completed and signed and all supporting documents must be provided at the time of application. Please do not send incomplete applications or applications without required evidence as these will not pass the eligibility review. Section 1Business Details: Business name:Click here to enter text.Address (including Postcode):Click here to enter text.Main contact name:Click here to enter text.Main contact email address:Click here to enter text.Main contact telephone number:Click here to enter pany registration number or UTR number: Click here to enter text.Registration date: Click here to enter text.Together with this form I provide the following documents: Please tick 2 of the below: FORMCHECKBOX _ Limited Company – certificate of incorporationor FORMCHECKBOX _Sole trader/ Self-employed – letter from HMRC showing registration dateand FORMCHECKBOX _Fully completed and signed Participant Entry, De Minimis Declaration and Consent forms (provided in annex 1) Are you VAT registered (please tick yes or no) FORMCHECKBOX _Yes FORMCHECKBOX _No What is the nature of your business? (max 200 words)If you are a Start Up please advise us of the legal structure you will use:Please advise us of your planned start date. (Start date is the date you start to promote your business or carry out your first trade, whichever is soonest)Section 2Project detailsWhat do you want to do? (max 200 words) Explain how this project will develop your business. (200 words)How are you going to do it (project plan)? Outline key tasks, estimating time required for each task.Explain the expertise and resources in your company to carry out this project. (200 words)What is the value of the project you are undertaking?What is the value of the grant applied for?What is the value of the match funding What is the source of the match funding?Section 3 Project costsPlease provide a breakdown of the project costs in the table below: (Include cost of employment for new jobs (if applicable), costs of equipment and services). Do not include recoverable VAT. VAT is not funded through the grant programme if it is recoverable. Component of ProjectEstimated CostCost ExplanationIs this an asset?Section 4Added ValueWould this grant fund investment enable you to:Deliver a project that could not otherwise happen; or enable the project to happen sooner; or enable the project to be larger; or enable the project to be of greater qualityYes ?No ?If the answer to the above is ‘yes’ please briefly explain how ERDF funding would enable this. Please also explain why this funding is necessary and why the company is not able to source this through other funding streams. Section 5:OutcomesThe aims of the Business Hot House and Invest4 Grant Programme are to help businesses achieve growth, create jobs, improve productivity, create innovation and develop new products for use both internally and externally. Please detail your expected outcomes. New full time jobs created:New part time jobs created (please detail hours):Increased turnover (please detail current and projected)Increase net profit (please detail current and projected)Innovation development Creation of new to firm products Creation of new to market products Other expected outcomes – please specify:Section 6Signed declaration:I declare that the information provided in this small grant application form is correct and that I may be required to repay any grant fund paid out to me or the detailed business on this application if any of the information is found to be untrueDate:Name:Position:Signature:Section 7Included DocumentsPlease tick all that apply Business Plan Previous 2 years full accounts Current year full management accounts Completed and Signed Business Hot House Application Form Any other documents – please detailInternal reviewOutcome (Pass or Fail)WhoSignedEligibilityDue DiligencePanel reviewAdded to database ................
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