Kernel Capital Funding Application Form by yTLGz9

VIEWS: 2 PAGES: 29

									V 6.0                                                                                                       Ref: K0003




                                          Accelerating Value Creation




                                         Application Form


Completing this Application Form:

The purpose of this form is to allow Kernel Capital to gain an initial insight into your business proposal and to
ascertain if it is suitable for investment consideration. All information received is covered by Kernel Capital
confidentiality.

Please read the Application Form in its entirety before completing it as concisely as possible. In the meantime, feel
free to contact us should you require further information or clarification.

Note: This is an important document and will be presented as received to the relevant Investment Committee.
Please adhere to the question format. Fields in grey require your input. Use the TAB key to quickly navigate to each
field.

Kernel Capital utilises a standard Term Sheet which is available on our website and the act of submitting this
Application Form for funding is taken as an indication of the applicant’s outline acceptance of these terms.

For internal use only

Form No:                                                     Date Received:

Attachment                                                   Received (Y/N)
Latest management accounts
Current share register
Tax clearance cert
Copies of latest 6 months of bank statements
Copy of latest filed annual return




                        KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                               KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                          -1-
V 6.0                                                                                                                    Ref: K0003



                                                    Table of Contents

COMPANY DETAILS...................................................................................................... 1

TRANSACTION DETAILS .............................................................................................. 3

PROMOTERS, MANAGEMENT TEAM, BOARD OF DIRECTORS (SERVICE) ............ 4

CAPITAL STRUCTURE .................................................................................................. 5

ENTERPRISE IRELAND AND OTHER GRANTS RECEIVED ....................................... 6

COMPANY FINANCIALS & KEY DATA .......... ERROR! BOOKMARK NOT DEFINED.6

DETAILS OF TOTAL DEBT ........................................................................................... 8

KEY PATENT DATA....................................................................................................... 9

INVESTMENT DETAILS ............................................................................................... 10

MANAGEMENT TEAM AND NON EXECUTIVE DIRECTORS (PROFILE) ................. 11

FINANCIALS ................................................................................................................ 13

PRODUCT / SERVICE .................................................................................................. 15

THE MARKET ............................................................................................................... 17

THE INDUSTRY ............................................................................................................ 20

COMPETITION ............................................................................................................. 21

SALES .......................................................................................................................... 22

COMPANY SWOT ANALYSIS ..................................................................................... 25




                           KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                                  KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                                -2-
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COMPANY DETAILS
 Company name:

 Company registered number:
 Date established:
 Industry sector:
 Business address:

 Your name & position:

 Contact details:                               Phone:           Bus:                      Mob:

                                                Email:
                                                Website:

                                                Address:



 Twitter ID/Blog address of the Company
 or promoter:

 % of sales export focused:                            %




                      KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                           -1-
V 6.0                                                                                                     Ref: K0003



 Describe your Company’s business
 opportunity in 100 words or less




 Enterprise Ireland HPSU approved?            Yes            Date Approved:

                                              No             Potential to qualify for HPSU status -SELECT-*

 Enterprise Ireland Development               Name:
 Advisor:                                     Tel:
                                              Email:
                                                  Name & Contact Details                    Reviewed this form
 Auditors:                                                                              Yes         No
 (If the Company has no Auditor please
 advise)
 Lawyers:                                                                               Yes         No
 Date appointed:

 Other Advisors:                                                                        Yes         No



 Bankers:




                     KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                           KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                       -2-
V 6.0                                                                                             Ref: K0003




TRANSACTION DETAILS

 Requested investment from Kernel:         €

 Simultaneous      investment      from    €
 Enterprise Ireland:

 Has this investment been approved by
 Enterprise     Ireland’s  Investment
 Committee and if so, when and for
 how much?


 Simultaneous investment from others:      €                                       From whom:




 Can you provide proof of these
 potential funds?

 Required timeframe for investment:
 How long will this investment fund the
 company for?

 Company valuation:                        Pre money €                             Post money €
 If an offer is made consistent with the   Yes      No
 applicants request will it be accepted
 by the applicant?


 Have you read our standard terms of       Yes      No
 investment as available on our website
 www.kernelcapital.ie ?




                      KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                            KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                        -3-
V 6.0                                                                                               Ref: K0003




PROMOTERS, MANAGEMENT TEAM, BOARD OF DIRECTORS (SERVICE)

 Name            Age       Position                     % Time          Length of    Exclusive to    Reviewed this
                                                        Committed       Service      the Company     form in full
                                                        to Company      with the
                                                                        Company
                                                                                     Yes    No       Yes     No



                                                                                     Yes    No       Yes     No



                                                                                     Yes    No       Yes     No



                                                                                     Yes    No       Yes     No



                                                                                     Yes    No       Yes     No



                                                                                     Yes    No       Yes     No



                                                                                     Yes    No       Yes     No



                                                                                     Yes    No       Yes     No




               KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                       KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                  -4-
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CAPITAL STRUCTURE

 Shareholder       Shareholder       Share         Share          %                  € Amount   Date       Repayable
 Name              Description       class         numbers        Shareholding       Invested   Invested   Date (BES)
                   SELECT



                   SELECT



                   SELECT



                   SELECT



                   SELECT



                   SELECT



                   SELECT



                   SELECT



                   SELECT



                   SELECT




Do you have a Shareholders Agreement? Yes            No

Please confirm that the Capital Structure outlined above agrees with current CRO filings         Yes       No

Please attach a copy of your current Share Register and your latest filed CRO Annual Return.




                      KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                            KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                        -5-
V 6.0                                                                                     Ref: K0003




ENTERPRISE IRELAND AND OTHER GRANTS RECEIVED

 Date              Amount awarded               Drawn down                Description




                KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                      KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                  -6-
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COMPANY FINANCIALS & KEY METRICS


                                  31/12/2010          31/12/2011         31/12/2012          31/12/2013     As at date of
                                                                                                             submission
                                        €’000               €’000              €’000               €’000           €’000
 Income Statement                                                                                           P/E __/__/__
 Turnover
 Cost of sales
 Gross Profit
 Overheads
 Net Profit before tax
 Balance Sheet                                                                                             As at __/__/__
 Fixed Assets
 Intangible Assets
 Current Assets
 Current Liabilities
 Long-term liabilities
 Net Assets
 Gearing                                                                                                   As at __/__/__
 Total Debt
 Issued Share Capital
 Total Cash
 Other Metrics                                                                                             As at __/__/__
 No. of employees
 No. of customers
 No. of products
 Market size - Europe
             - USA
             - Other




 Non operating cash               31/12/2010          31/12/2011         31/12/2012          31/12/2013     As at date of
 raised                                €’000               €’000              €’000               €’000      submission

 Equity
  rants
 Loan notes

Please attach a copy of your latest management accounts

Please attach a copy of bank statements for each bank account for the preceding 6 months from date of application

Please indicate if you have a current tax clearance cert and if so, please attach




                         KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                               KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                           -7-
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DETAILS OF TOTAL DEBT

 Loan Facility        Terms

 Bank




 Directors’ Loans




 Shareholder Loans




 Other




                     KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                           KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                       -8-
V 6.0                                                                                                    Ref: K0003




KEY PATENT DATA

 Patent #     Named             Territories          Description                      Status      Freedom to
              Inventor          filed/granted                                                     operate/other




 Patent Agent Contact
 Details:




                        KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                          -9-
V 6.0                                                                                                   Ref: K0003



Note: For the remainder of this questionnaire you may answer questions as briefly or detailed as you deem
appropriate. Complete accurate information concisely stated is appreciated.


INVESTMENT DETAILS

1.      How do you envisage the timing and method of returning invested capital?




2.      Has the Company entered into any contractual arrangement whereby a third party is paid a fee on
        completion of the fundraising or have any other commitments been given to such bodies regarding the
        current or future rounds? If so, provide details.




3.      To which other sources of capital have you applied for funding and when?




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                             KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                        - 10 -
V 6.0                                                                                                          Ref: K0003




MANAGEMENT TEAM AND NON EXECUTIVE DIRECTORS (PROFILE)

1.             Please provide brief biographies of the management team (biographies should include relevant
               professional experience, responsibility within the company along with details of previous roles held with
               dates, job titles etc).

          a.




      b.




     c.




     d.




                              KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                                    KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                               - 11 -
V 6.0                                                                                                     Ref: K0003



2.      For all personnel please complete the following, commencing with promoters, non-executives and
        management:

Name                      Position                  Salary           % Time          Length of   Exclusive to
                                                                     Committed       Service     Company
                                                                     to Company      with the
                                                                                     Company
                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No

                                                    €                                            Yes     No



3.      How do you believe that the management team can be improved?




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                             KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                        - 12 -
V 6.0                                                                                                      Ref: K0003


FINANCIALS

1.      Which key assumptions is your financial projections model most sensitive to?




2.      What sources of funding are currently available to the business? What is the current cash on hand as of
        today?




3.      What level of capital do you anticipate is necessary to achieve a sustainable market position in both the
        short-run and the long-run?




4.      What is the rational supporting your stated valuation of the business today?




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                         - 13 -
V 6.0                                                                                           Ref: K0003


5.      How will the funding proceeds be used?




                      KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                            KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                       - 14 -
V 6.0                                                                                                         Ref: K0003




PRODUCT / SERVICE

1.      Describe your existing and proposed product or service and its application to the market opportunity.




2.      At what stage of development is the current product suite (e.g. feasibility, proof of concept, patented, ready
        for distribution etc?)




3.      Outline the future product development roadmap for your current offering.




4.      What differentiates your company’s product or service and provides a sustainable competitive advantage?




                        KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                         - 15 -
V 6.0                                                                                                     Ref: K0003



5.      What are the key issues that need to be addressed to improve your company’s product or service?




6.      Have you commissioned any specific reports on your company’s technology/processes? If so, please
        outline.




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                             KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                        - 16 -
V 6.0                                                                                                   Ref: K0003




THE MARKET

1.      Describe the target market for your product or service.




2.      What is the geographical target market for your product or service?




3.      Is the market emerging, stable or declining?




4.      What is the market’s estimated value per annum in the short-term (2 years) and medium-term (5 years)
        growth?




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                         - 17 -
V 6.0                                                                                                         Ref: K0003


5.      Have you reviewed Independent Market Reports on the Industry and Product Area? If so, provide the title,
        author and date for each report below.

               Title                                   Author                                Date Published




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                             KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                        - 18 -
V 6.0                                                                                            Ref: K0003


6.      Are the demand drivers for your product or service identifiable?




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                         - 19 -
V 6.0                                                                                                       Ref: K0003




THE INDUSTRY

1.      Describe the competitive landscape of your target market, with market share and revenue information.




2.      Where does your company fit within the supply chain of the industry?




3.      What influence / alliance / relationship does your company have, or have the potential to hold, with players
        in the industry?




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                         - 20 -
V 6.0                                                                                            Ref: K0003


COMPETITION

1.      Who are your major competitors and how are you differentiated from them?




2.      Do barriers exist that will inhibit your competitors from doing what you’re doing?




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                         - 21 -
V 6.0                                                                                                Ref: K0003


SALES

1.      What is the current or potential customer profile?




2.      What is the proposed short-term (2 years) and long-term (5 years) revenue model?




3.      Briefly describe the current sales and marketing plan.




4.      What percentage of your target market do you aim to capture within a three-year timeframe.




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                         - 22 -
V 6.0                                                                                                          Ref: K0003


5.      List your top 5 key existing or target customers below.

EXISTING CUSTOMERS                                     TARGET CUSTOMERS
1.                                                     1.

2.                                                     2.

3.                                                     3.

4.                                                     4.

5.                                                     5.




6.      Has a customer already bought your product or service for cash? If so, please describe recent sales.




7.      If you are a pre revenue company, when will the first commercial sale be completed?




8.      Who will buy your product/service and why will they buy it?




                       KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                         - 23 -
V 6.0                                                                                                   Ref: K0003




9.      How will you sell and get your product to the end-user (distribution)?




10.     How much will your average client spend with you in a year and how have you calculated that figure?




11.     Briefly describe the sales process and timeline from identifying a prospect to getting paid.




                        KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                         - 24 -
V 6.0                                                                                           Ref: K0003


COMPANY SWOT ANALYSIS
1.      Please populate the SWOT table below.

                    Strengths                                                      Weaknesses
                                                               




                  Opportunities                                                      Threats
                                                               




                      KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                            KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                       - 25 -
V 6.0                                                                                                      Ref: K0003



Thank you for completing this Application Form.

We have high regard for those with entrepreneurial spirit and recognise the significant obstacles and
challenges faced by start up and early stage businesses. We are committed to delivering a standardised and
transparent investment process. This Application Form is substantial and in completing same you are
providing us with detailed and commercially sensitive information on your business. We will at all times treat
this information within the terms of our confidentiality agreement and with the respect that is incumbent
upon us. The purpose of the detailed process is to allow us to provide you with a timely and direct response
to your Application Form. We know that you will have put time into this and should Kernel Capital decide
not to proceed this decision may be difficult to accept. We work on the principle that when declining an
opportunity a prompt and clear response although unfavourable to the applicant is more in their interest
than mixed messages and no progression. Should Kernel Capital or indeed any other provider of equity
decline your proposal it is important to recognise that this is not necessarily a value judgement on the
commercial merit of the opportunity presented. Opportunities may be declined because they do not qualify
under the criteria of the particular Fund, they may not suit the Fund portfolio, the venture capital firm may
believe they have little capacity to add value to the project, the company may not be suited to an institutional
investor or indeed, although an opportunity may be strong there may be similar applicants whom the equity
provider believe are more suited to them. In submitting your Application Form please remember that it is
not reviewed in isolation but in the context of other existing and potential future submissions. In applying to
this Fund you must recognise that all investment decisions are at our sole discretion and there is no obligation
upon us to explain or justify the rationale behind such decisions.

Please submit your completed Application Form via email to boi_seedfund@kernelcapital.ie or to your
Kernel Capital Account Executive, with requested attachments and any other documents which you feel are
relevant to the Application Form.

This Kernel Capital Application document is submitted on the basis of the completed information, which is correct
to the best of my knowledge and belief.


I agree                                                   Date:

Full name:                                                Title:
                          (printed)




                        KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                              KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                         - 26 -
V 6.0                                                                                           Ref: K0003



For Internal Use Only – Notes




                      KERNEL CAPITAL IS A TRADING NAME OF KERNEL MANAGEMENT PARTNERS LIMITED,

                            KERNEL CAPITAL IS REGULATED BY THE CENTRAL BANK OF IRELAND

                                                       - 27 -

								
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