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									Fast Track

The Rural Development Programme for England:
New LEADER Approach Application Form


Applicant Organisation:

Name of project:

For office use only:

Date received:                                   Project reference no:

RDPE measure

Before you complete this form please ensure that:
     You have read the supporting application guidance that should have been provided to
        you with this form or is available at RDPE - The new LEADER approach
     You have completed an Expression of Interest form and it has been endorsed by your Local
        Action Group (LAG);
     Your project fits the objectives of the wider Rural Development Programme for England (RDPE).
Further information is available by contacting your Local Action Group. We also advise that you
familiarise yourself with the Local Development Strategy for your area available on the RDPE website
or through your LAG coordinator.
Before you submit this form, please ensure that:
      You have completed the checklist on page 2 and the form is signed by an appropriate member
        of your business / organisation / group (e.g. chair, vice-chair, secretary or treasurer).
      You have answered every question as fully as possible
        (failure to provide key details may delay the decision-making process).
      You have provided appropriate supporting documentation
        (e.g. letters of support, planning permission, proof of match funding).
If you are completing the form electronically, all of the boxes can be expanded. If you are completing
the form by hand, please firmly attach any further information you wish to include to the back of the
form and clearly reference the question it relates to. We would advise that any additional information
provided is as relevant to question as possible. Please return your completed form to:
Louise Johnson, East Durham LEADER,
Park House, Station Road, Lanchester, County Durham DH7 0EX.
Email: Louise.Johnson@eastdurhamleader.org.uk                Tel: 01207 529621
Further information about East Durham LEADER visit the website at
www.durhamrcc.org.uk/eastdurhamleader




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Submission checklist

                                                                            Yes   No   N/A

All questions answered fully

Copy of signed constitution enclosed (if applicable)

Copy of Health and safety policy attached

Copy of Equal opportunities policy attached

Confirmation of match funding provided

Planning or other legal permissions and consents enclosed (if applicable)

Letters of support

Any annexes relating to specific information the LAG wishes to
capture (eg additional outputs) Further information available
from your LAG Co-ordinator.
Form signed by appropriate member of business/ organisation/ group




v6.2 June 11                                                                            Page 2
Section A: Your Organisation
1. Name of your organisation/group/business:


2. Registered address of the
   organisation/group/business:



3. Postcode:

4. Main contact:

5. Position held:

6. Contact address:




7. Postcode:

8. Telephone number:

9. E-Mail address:

10. Will the above contact be responsible for managing the project?   Yes   No

11. If no please can you also provide the
    contact details for the project manager?

How would you describe your organisation? (please tick)

     12. Registered charity                      Registration no:

     13. Company limited by guarantee            Registration no:

     14. Company limited by shares               Registration no:

     15. Community interest company              Registration no:

     16. Unincorporated club or association

     17. Public sector

     18. Other (please specify)

     19. Do you have a VAT number?                  Yes      No

          If yes can you claim back VAT             Yes      No

          If yes, please do not include VAT      VAT Number:
          in the finance tables in Section C



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20. Does your group have a constitution or a set of rules for conducting           Yes   No
    the business of the group?
    If yes, please provide a copy with this application.

21. When was your organisation/ group/ business established?


22. Has your organisation, group or business previously received public funding?   Yes   No

If yes, please answer the following questions

i) What was the funding source?
(eg ERDP, LEADER+, ERDF, ESF)

ii) How much was the grant?                            £

iii) What was it for?


23. Does your organisation have an equal opportunities policy?                     Yes   No
(if yes please attach to application)
24. Does your organisation have a health and safety policy?                        Yes   No
(if yes please attach to application)

If you answered No to either question 25 or 26 above please be aware you will
need to develop them if your funding bid is to be successful.




v6.2 June 11                                                                             Page 4
Section B: Project Details

1. Name of project

2. Planned start date                                Planned end date

3. Is planning permission required? If yes, you must provide evidence that it   Yes   No
has been granted before we can approve your project. (See www.netregs.gov.uk)
4. Please provide a description of the project. (150 words max)
   What are the objectives, outputs and expected outcomes of the project?
   Describe what actions have taken place so far.
   List all partners involved in the project.




5. Please describe exactly what the funding will be used for? (150 words)




v6.2 June 11                                                                           Page 5
6. Why is this project needed?
   e.g. Scale of market demand or need for your product or service. (150 words)




7. Provide a description of how the project will be managed and delivered. (150 words).
    Who is responsible for the project on a daily basis?
    Who will be submitting claims, progress reports?
    Who will be responsible for document retention?
    Explain how you will manage the cash flow.




v6.2 June 11                                                                              Page 6
Section C: Project Finances
Please remember that your request for RDPE support is limited to a maximum of £14,999 under
the Fast Track application process.
You should provide as detailed a breakdown as possible of what your project will cost in the
table provided.
Please note: you can not start to incur costs prior to approval. Expenditure claimed for work
already carried out before this date will be deemed as ineligible and not paid.
1. Table A: Expenditure breakdown
Please use the table to describe the full costs and funding package associated with your project.
If you are unable to reclaim VAT the costs provided should include VAT where applicable, otherwise the
costs should exclude VAT.
Capital costs                            2011/12          2012/13           2013/14             Total
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
Revenue costs                                                                                     £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
                                                                                                  £0
Total project costs                          £0                £0                £0               £0

Do the above costs include VAT?    Yes     No




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2. On what basis are the costs in table A calculated?
You must address each cost individually E.g. PC estimated costs based on 3 quotes.
(Please continue on a separate sheet if required)
Item of Expenditure       Basis of cost calculation




3. Table B: Project Funding Package
                                   2011/12     2012/13    2013/14      Total £       % of Total
                                      £           £          £
RDPE Funding                                                                     0

                                                                                                  Approved        Applied
Private Sector Funding                                                                                              for
Sources
1.                                                                               0
2.                                                                               0
3.                                                                               0
4.                                                                               0
5.                                                                               0
Total Private Sector                       0          0           0              0

Other Public Sector Funding
Sources
1.                                                                               0
2.                                                                               0
3.                                                                               0
4.                                                                               0
5.                                                                               0
Total Public Sector                        0          0           0              0

                          1
Applicants Own Labour                                                            0
In-Kind Contributions                                                            0
Total                                      0          0           0              0



1
    Please refer to Annex B in the supporting application guidance. Any costs prior to approval are ineligible.
v6.2 June 11                                                                                                       Page 8
4. Will your project generate any revenue?                                                 Yes        No
N.B. If revenue will be generated please attach forecasts for three years to this application form.

5. Table C: RDPE LEADER Expenditure Profile
Please use the table below to profile the project expenditure identified in Table A. Please note that claims will only be paid at the approved intervention
rate, the profile below must therefore reflect this. Claims should be itemised on a quarterly basis.

                                   2011/12                                      2012/13                                2013/14

                      Q1        Q2         Q3          Q4         Q1         Q2         Q3            Q4       Q1         Q2         Q3           Total
                    Apr-Jun   Jul-Sep    Oct-Dec    Jan- Mar   Apr- Jun    Jul- Sep   Oct-Dec    Jan- Mar    Apr-Jun    Jul-Sep    Oct-Dec

 a) Total Project                                                                                                                                         £0
    Expenditure

 b) LEADER                                                                                                                                                £0
    funds to be
    claimed
 c) Claim rate                                                                                                                                                %
    (b/a) %




v6.2 June 11                                                                                                                                          Page 9
Section D: RDPE Milestones, Outputs and Outcomes
1. Project Milestones: Please indicate below the key milestones for your project.
Milestones Description                                                                      Date




2. Project Outputs:
Please indicate on the table below the number of outputs your project will deliver. You will need to
evidence any outputs you claim, please refer to Annex D of the supporting application guidance.
Output                                   Number to be delivered
                                                2011/12          2012/13          2013/14                Total
                                    2
Number of businesses supported                                                                              0
Jobs created3                                                                                               0
Jobs safeguarded2                                                                                            0
Individuals benefiting4                                                                                      0
New tourism activities supported                                                                             0
Additional day visitors                                                                                      0
Additional overnight stays                                                                                   0
Farm diversification projects5                                                                               0
New products introduced                                                                                      0
New techniques introduced                                                                                    0




2
 When reporting outputs this data will need to be broken down into micro-small/ medium/ semi-large/ other.
3
 When reporting outputs this will need to be broken down into on farm/ off farm and Male<25/ Male>25/
Female<25/Female>25.


4
  When reporting outputs this data will need to be broken down into Male<25/ Male 25-40/ Male>40/ Female<25/
Female 25-40/ Female>40.
5
  When reporting outputs the activity for each diversification project will need to be provided.
v6.2 June 11                                                                                             Page 10
If training outputs will be generated by your project please fill in the table below:
Training Output                                    Number to be delivered
                                                              2011/12              2012/13              2013/14
                                      6
Number of training days delivered
Estimated number of recipients who will be:
          Micro-enterprises
          Non-profit organisations
          Public organisations
          Individual Farms
          Others
Number of participants who complete
training activity7
Number of participants who are expected to
apply newly acquired skills in practice
Number of training days

3. Project Outcomes:
Please describe any other benefits that your project will deliver (150 words).
It is important that you try to make these outcomes as measurable, achievable, realistic and specific as
possible and try to include a date when the outcome will be achieved by.




6
    Note 1 training day = 8 hours
7
  When reporting outputs the recipients of training will need to be broken down into Individual farmers male <25/
Individual farmers male >25/ Individual farmers female <25/ Individual farmers female >25/ Others female <25/
Others female >25/ Others male <25/Others male >25

v6.2 June 11                                                                                               Page 11
Section E: Sign off
The form must be signed by a person in your group / organisation / business who is authorised
to do so. This could be the chair person, vice chair, secretary or treasurer.

Please note that as this investment from the RDPE will involve expenditure of public resources,
there is public interest in how the investment is spent. In addition, the EU Regulations require
us to make a certain amount of information available about who has received investment under
the Rural Development Programme. Therefore the RPA will publish an annual list of all
receiving financial support under the Programme, which will be available on a Government
website. Details disclosed will include the name of business/ organisation, amount of funding
received and the locality (usually at Parish level).

Declaration and Undertaking
Is your business or organisation solvent, and does it have a sound and satisfactory                         Yes         No
delivery record? If not, please provide details.
This information will be treated in the strictest confidence.

Has your organisation ever been requested to repay a grant?                                                 Yes         No

If Yes, please give details on a separate sheet of paper on the grant, the amount and details of the
circumstances. This does not necessarily affect your chances of being awarded a RDPE grant.


I confirm that, to the best of my knowledge and belief, all the information in this RDPE LEADER
application is true and correct. I understand that the details in this application will be shared between
the Local Action Group, One North East and Northumberland County Council, Durham County
Council, DEFRA, the RPA and EAFRD; and that it is subject to RDPE publicity and procurement
requirements should the application be successful. I agree to any disclosure or exchange of
information about this application (including the content of any declaration or undertaking) which the
department considers appropriate for the administration, evaluation, monitoring and publicising of the
scheme(s) concerned.

Signed                                                         Print name

Position                                                       Date




Data Protection Defra is the data controller in respect of any personal data that you provide to us.
Your personal data will be protected in accordance with the Data Protection Act 1998. We will use the data:
     To support the application to which it relates
     For the administration of the Common Agricultural policy (CAP), and the Rural Development Scheme for England (RDPE)
      and to keep you informed of developments within schemes
     In relation to the production and safety of food.
     In relation to the management of land and other environmental controls.
     In relation to animal health and welfare.
     In relation to occupational health and welfare.
When it is necessary to do so, we may also pass data to other organisations, for example:
     HM Revenue and Customs - for import or export purposes;
     Local authorities - for milk, health or cross compliance purposes; or The Environment Agency, Natural England
      and the Forestry Commission, for the administration of the Common Agricultural Policy.




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