Certificate of Employment as Senior Auditor

							                                                                                            Grant Claim Form 1
                                                                                            General / Declaration
                                                                                            Grant Ref . No.______________

                                                                                            Claim No. __________________



Section 1 : Declaration and Claim Indicator
Please read the following carefully before completing the claim form:            (v) Pass section 1 and Forms(s) 2- 14 (as appropriate) to
1. This form is used when making claims against Shannon                          your Auditor when completed. The Auditor will then validate
Development grants.                                                              the expenditure as claimed, attach the required Certificate and
2. The forms must be typed or clearly printed.                                   lodge all the documents with Shannon Development.
3. Grant installments may be claimed where eligible costs have                   (vi) In the case of Trade Fair Participation an Auditor's Cert
been incurred and paid by the grantee.                                           is only required if the cumulative expenditure exceeds €12,697
4. To claim grants from Shannon Development it is recommended                    (vii) Collate compliance documents A-N as required
that the folowing be done:                                                       (viii) When all compliance documents have been obtained, attach
(i) Read Grant Claim Form 1, carefully before completing                         to completed Section 2 and send to: The Manager, Grant
(ii) Refer to Grant Claim Indicator to identify the Grant Claim                  Payments Section, Shannon Development, Shannon,
Form(s) to be completed and the documents to be submitted in support             Co. Clare
of you Claim.                                                                    5. Please ensure that all claim forms are are correcty and fully
(iii) Indicate in Section 2, by way of a circle, the documents relevant to       completed in accordance with the instructions on each form.
your claim.                                                                      FAILURE TO DO THIS WILL RESULT IN THE CLAIM BEING
(iv) Separate sections 1 and 2 of the Grant Claim Form 1                         RETURNED



Name of Grantee: ________________________________________________________________________
Address: _________________________________________________________________________________
Telephone: __________________________________ Fax No: ____________________________________
Name of person with responsibility for the company:__________________________________________
Email Address: __________________________________________________________________________


Declarations
I/We hereby declare that:
(i) The cost as stated on the attached claim have been paid in full by th grantee company and are net of the following : trade and/or cash
discounts, commissions, rebates, V.A.T. and Employer P.R.S.I. Contributions.
(ii) Foreign currency amounts have been converted to € using the rate of exchange at the date of payment and thus represents the actual
€ cost incurred.
(iii) The assets covered in this claim are new and will not subsequently be leased, sub - let, relocated or disposed of without the prior
written consent of Shannon Development ( except for expenditure included in Grant Claim Form 13)
(iv) The costs included in this claim have not been included in previous claims to Shannon Development, any other Government Agency, the
EU, or any grant.
(v) I/we have no objection to Shannon Development contacting our insurance Agents, Auditors, Solicitors or any other Governmant
Agency in realtion to any matter pertaining to this grant claim.
(vi) The information contianed in this claim documentation is true, accurate and complete.


Remarks (if appropriate) :                ___________________________________________________
____________________________________________________________________________________________


This Grant Claim Declaration to be signed in accordance with the following criteria:
(i) Irish Incorporated Company - by Managing Director or two Company Directors
(ii) Overseas Incorported Company - by the most Senior Executive resident in Ireland
(iii) Individuals - by the Grantee(s)


Signature:     _______________________________             Title: ______________________        Date: _________________
Signature:     _______________________________             Title: ______________________        Date: __________________
                                        Grant Claim Indicator
Please note: Not all of the conditions below may apply to your grant - please refer to your Grant Agreement
This schedule below lists the grant available and specifies the claim forms and support documents (certificates of
compliance) to be submitted in respect of each grant type.

Pleese read the following instructions carefully.
(i) Indicate carefully with a tick the grant(s) covered by this claim.
(ii) Identify Claim Form(s) 2-15 and doucuments of compliance A - N relevant to your grant claim
(iii) Complete Claim Form(s) 2-15 and obtain documents of compliance A - N as appropriate

Note: When documentary evidence of compliance (documents A -N) have been submitted, it is not needed to be
resubmitted with subsequent claims unless:
(i) Requested to do so by Shannon Development
(ii) There is a change in circumstances (e.g Change of company structure/ownership, equity levels, insurance, etc)

                               MANUFACTURING INDUSTRY PROJECTS ONLY

Capital Site & Buildings(incl. Mods)          Complete Claim Form 2 & submit documents A,F,G,H,I,J,L,M & C or E
Capital Plant & Machinery                     Complete Claim Form 3 & submit documents A,F,G,H,I,J,L,M & C or E
Training                                      Complete Claim Form 5 & submit documents J,L,M & D or E
Rent Subsidy                                  Complete Claim Form 8 & submit documents B,G,J,L,M & D or E
Technology Acquistion                         Complete Claim Form 10 & submit documents J,L & C,M or E
Technology Capability                         Complete Claim Form 3 & submit documents G,I,J,L,M & C or D
Trade Fair Participation                      Complete Claim Form 16 & submit documents D,J,L & (M)
Leasing Plant & Machinery                     Complete Claim Form 13 & submit documents A,F,G,H,I,J,L,M & C or E
Research & Development Facilty                Complete Claim Form 14 & submit documents A,F,G,H,I,J,L,M & C or E


                               SERVICE INDUSTRY PROJECTS ONLY

Capital Site & Building(incl. Mods)           Complete Claim Form 2 & submit documents A,F,G,H,I,J,L,M & C or E
Capital Plant & Machinery                     Complete Claim Form 3 & submit documents A,F,G,H,I,J,L,M & C or E
Training                                      Complete Claim Form 5 & submit documents J,L,M & E
Rent Subsidy                                  Complete Claim Form 8 & submit documents B,G,J,L,M & C or E
Leasing Plant & Machinery                     Complete Claim Form 13 & submit documents A,F,G,H,I,J,L,M & C or E
Research & Development Facilty                Complete Claim Form 14 & submit documents A,F,G,H,I,J,L,M & C or E
Market Research                               Complete Claim Form 11 & submit documents D,J,L & M

                               ALL OTHER PROJECTS


Research & Development                        Complete Claim Form 4 & submit documents J,L,M,N & D or E
Feasibility Study                             Complete Claim Form 6 & submit documents D,J,L & M
Employment                                    Complete Claim Form 9 & submit documents A,F,J,K, L,M & C or E
Management Development and                    Complete Claim Form 15 & submit documents J,K,L,M & C or E
Consultancy


                              SPECIAL/PERFORMACNE CONDITIONS
Some grant approvals have special or performance related conditions included as a precondition of payment.
Evidence of compliance with these conditions should be obtained for submission to Shannon Development when
requested (the special/performance related conditions are specified in the Grant Agreement).


Send section 1 and the relevant completed Claim Forms 2 - 15 to your Auditor
Section 2: General Grant Conditions (see notes below)
Please circle the letter, to relect the documents accopmanying this section.

Title                       A      Solictor's letter confirming that the grantee company holds clear and valid title to the
                                   site and buildings where ther grant aided undertaking is being carried on.
                                   The nature of the title should be specified, i.e. Leasehold or Freehold.
                                   If Leasehold the terms of the lease should be confirmed.
                            B      A copy of the executed lease to the site and premises where the grant aided
                                   undertaking is been carried on.

Company                     C      Irish Registered Company : Written confiramtion from the company's solicitor that
Incorporation                      the grantee company has been properly incorporated and is acting within its powers
                                   in carrying on th eundertaking contracted for in the Grant Agreement.
                            D      Irish Registered Company: A copy of the Certificate of Incorporation for the grantee
                                   company.
                            E      Overseas Registered Company:Written confiramtion from a lawyer practising within
                                   the jurisdiction within which the overseas company is incorporated that the company
                                   is properly incorporated and is acting within its powers in entering into the Grant
                                   Agreement.
                                   Irish Branch of Overseas Registered Company: Written confirmation from the
                                   company's solicitors that all documents have been lodged with the Registrar of
                                   Companies as required by Section 352 of the Companies Act 1963.

Equity                      F      Ordinary Share Capital Only: Auditor's certificate confirming that the issued and
Investment                         fully paid up share capital of the grantee company as been raised in accordance with
                                   the terms outlined in the Grant Agreement. The number and value of the issued share
                                   and paid up shares should be specified.
                                   Ordinary Share Captial and other Equity Equivalent (as specified in Grant
                                   Agreement)
                                   Auditor's certificate confirming the value, type and source of each element of the
                                   equity equivalent raised for grant matching purposes e.g.
                                    ~ Issued and fully paid up at par Ordinary Share Capital of € (Specify) increased
                                   by way of cash investments by promoters.
                                    ~ Issued and fully paid up at par Ordinary Share Capital of € (Specify) increased
                                   by capitalisation of retained earnings.
                                    ~ Subordinated loans of € (Specify) issued in accordance with the terms and
                                   conditions of the Grant Agreement.
                                    ~ Retained earnings transferred to a non-distributable capital reserve for the duration
                                   of thre Grant Agreement.
                                    ~ Preference Shares
                           G       Fixed Assets: Written statement from the grantee's insurance broker detailing the
                                   following information.
                                    ~ The sums insured on the (i) Buildings and (ii) Plant and Machinery.
                                    ~ Confirmation that the perils of fire and explosion are covered
                                    ~ Confirmation that the policy is effective on a reinstatement basis
                                    ~ Confirmation the Shannon Development will be notified in the event of the policy
                                   being cancelled or materially altered.
                                    ~ The renewal date of the policy.
                            H      Consequential Loss: Written statement from the grantee's insurance broker
                                   confirming
                                    ~ The exixtence of consequential loss insurance cover to indemnify adequately the
                                   grantee against losses or costs resulting from fire and explosion.
                                    ~ The policy has been set up in accordance with good commercial practice.
                                    ~ The sums insured are adequate , based on the projected figures for the current
                                   indemnity period
                                    ~ Shannon Development will be notified of any material alteration in the policy or its
                                   cancellation
Environmental              I     Completed Environmental Assessment Form, a copy of which is appended to the
Control                          Grant Offer.



Grant                     J      Signed and dated acceptance of the Letter of Offer or Grant Agreement duly
Agreement                        exercised


Employment                K      Copies of emloyment contracts for all employess on which subsidy is being claimed.
Contracts                        The contract should be dated and signed by both the company personnel
                                 representative and the employee.

Tax                       L      Current Tax Clearance certificate issued by the Revenue Commissioners
Clearance

Auditor's                 M      Completed Auditor's certificate. Claims for Trade Fair Participation should be
Cert                             accompanied by an Auditor's cert if accumulative expenditure exceeds €12,697


Progress                  N      Current progress report on R & D project status
Report


Send Section 2 and relevent compliance documents A - N to Shannon Development

Please read the following instuctions carefully:
(i) Complete all area's relevent to your claim
(ii) This section 2 of Claim Form 1, together with all the relevent documents A - N should be lodged directly with
Shannon Development at the address below. Please note that processing off this claim will commence on receipt of the
Auditor's Certificate (plus accompanying documentation) . It is therefore important that the relevant documents
attachements to this Section 2 be submitted to Shannon Development prior to the Auditor 's Certificate.
The Manager, Grant Payments Section, Shannon Development, Shannon, Co Clare
Phone 061 - 710237                              Fax: 061 - 710772


Dear Sirs,

Re Grant Reference No : _________________________________________________________

Name of Company: _____________________________________________________________

Please find attached all the relevant documents as required by Shannon Development to confirm compliance with the
conditions as specified on page 3.
Grant Claim Form 1, Section 1 and the appropriate Grant Claim Form(s) have been/ will be submitted to my Auditor
for certification of the claimed expenditure.

The Name and Address of my Auditor is :

Name:    __________________________________________________________
Address: __________________________________________________________
Name of Contact Person:    ________________________________________
Telephone: _______________________________________________

Yours faithfully,

Name:        _____________________________________            Signed:     __________________________________
Title:       _____________________________________            Date:       __________________________________