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Number of enterprises


Number of enterprises

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Important notes for completing this form.

This form should be used to claim interim payments. This payment will be the ESF
contribution of the total eligible expenditure (less revenue), declared for the profile period.

The date of your claim must match the intervals at which you identified costs and activities on
your Project Profile form, and you must declare how much you have spent on the project at
the date stated.

All figures must be cumulative, with the exception of ‘number of beneficiaries’, section 3C,
and ‘number of companies supported’, (if applicable) at section 6. The entries in these boxes
must show the total number of beneficiaries in training at the profile date, or where
applicable, the number of companies assisted.

The signature must be original and no correction fluid should be used on any part of this

You must provide the following information for your project, from the date the project
started, to the date of the profile period. We need this information to monitor the
delivery of ESF programmes in England and to meet the data requirement of the
European Commission. Full data for your project will be collected at the Project
Closure stage.

This form must be completed on time, and returned within four weeks of the end date
stated on the profile. Failure to do this will delay your interim payment and may impact
on the achievement of programme expenditure targets.

                                              Page 1
Dossier number
Project name
Profile period. (This must be the same
date as agreed on your ‘project profile
and advance claim’ form.

1. Financial breakdown. NOTE: all financial entries must be cumulative.

Please enter your eligible costs, in the following tables.

A(1)    Staff costs
A(2)    Profile costs
A(3)    Variance (% age)

If applicable, explain why the staff costs differ from the original estimate by more than

B(1)    Beneficiary costs
B(2)    Profile costs
B(3)    Variance (% age)

If applicable, explain why the beneficiary costs differ from the original estimate by
more than 15%

C(1)    Other costs
C(2)    Profile costs
C(3)    Variance (% age)

If applicable, explain why the other costs differ from the original estimate by more
than 15%

                                             Page 2
2. Financial summary

 A   Total eligible expenditure. (This must
     equal the sum of boxes A1, B1 and
 B   Revenue

 C   Total ESF eligible expenditure (A – B)

     Total profiled ESF eligible expenditure



                                          Page 3
Beneficiary characteristics. If your project is providing support to individuals, please
complete the following questions:

3. Starters and leavers. Enter the number of starters and leavers.

                                                                         Number of beneficiaries who are
                                                                         from an ethnic
                                 Male         Female      Total          minority group   disabled
 A   Number of
     beneficiary starters
 B   Number of ESF
     beneficiaries who
     have left (cumulative)
B(1) completers
B(2) early leavers
 C   Number of ESF
     beneficiaries still on
     the project at date of

NOTE : In A and B, show all starters and leavers from the date your project started. Box A,
minus Box B (total), must equal the entry in box C. B1 plus B2 must equal the figure entered
in B.

4. Beneficiary destinations. What happened to those who completed their training, or left
the project early ? (Cumulative).

                                                                            Number of beneficiaries who
     Destinations.                                                          from ethnic
                                       Male     Female           Total      minority groups disabled
A    In employment (including
     self or part time
B    In another positive
C    Unemployed
D    Not known and others
E    Totals

NOTE : the totals in line 4E, must agree with the entry in B (totals) above.

5. Qualifications. Enter the number of completers/early leavers who have gained a
qualification. (Cumulative).

                                                                    Number of beneficiaries who are:
     Number of leavers                                              from ethnic
     gaining a qualification    Male      Female         Total      minority groups     disabled
A    completers
B    early leavers
     Totals of A and B.

                                                Page 4
6. Companies supported. Only complete this box, if your project is providing support to
companies. Please give the following information.

                                                   Number of enterprises.
A   Enterprises with less than 250
B   Enterprises with 250 or more
    Total of A and B.

Thank you for completing the monitoring part of the form. The information that you
have provided will help us to measure the achievements of ESF in England.

Please comment in the box below, on the project progress to date.

                                          Page 5
7. Summary sheet.

Please enter the following information.

Profile period. (This must be the same as the
period shown on page 1).

Staff costs. Box 1A (1)
Beneficiary costs. Box 1B (1)
Other costs. Box 1C (1)
Total costs (gross). Box 2 A
Revenue. Box 2 B
Total costs (net). Box 2 C

Number of starters. Box 3 A
Number of completers. Box 3 B (1)
Number of beneficiaries. Box 3 C
Number of early leavers. Box 3 B (2)
Number of companies supported. Box 6 Total

                                             Page 6

I certify that:

The expenditure declared is eligible for ESF purposes and has been spent on the
project. I also confirm that the project activities / outputs are accurate.

I undertake to repay, on demand, any or all European Social Fund money paid, if after
investigation the project has not been carried out in accordance with the regulations
or application.

I undertake that is my responsibility to declare any significant changes to the project,
in accordance with the ESF Contract and Applicants Guidance.



Print name.

Position in organisation.

Office stamp.

If you do not have an official stamp, then you should attach a copy of your letterhead to this claim.

All Interim Claim forms MUST now be accompanied by an Expenditure and Revenue Work
Sheet – ERWS (see attached). Payment will not be made unless the appropriate ERWS is
completed and securely attached to your Interim Claim form.

                                                Page 7

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